title: Emergence of Klebsiella pneumoniae ST273 Carrying blaNDM-7and ST656 Carrying blaNDM-1in Manila, Philippines.
abstract: We sought to determine the epidemiology of carbapenem-resistant Enterobacteriaceae and to investigate the emergence of carbapenem-resistant Klebsiella pneumoniae in two teaching hospitals in Manila, Philippines. We screened 364 Enterobacteriaceae for carbapenem resistance between 2012 and 2013 and detected four carbapenem-resistant K. pneumoniae isolates from three different patients. We used whole genome sequencing to determine the antibiotic resistance profiles and confirmed the presence of carbapenemase genes by multiplex PCR. We used multilocus sequence typing and PCR-based replicon typing to genetically characterize the carbapenem-resistant isolates. The carbapenemase gene blaNDMwas detected in K. pneumoniae isolates from two patients. The first patient had ventilator-associated pneumonia and lumbar shunt infection from K. pneumoniae ST273 carrying blaNDM-7. The second patient had asymptomatic genitourinary colonization with K. pneumoniae ST656 carrying blaNDM-1. The third patient had a gluteal abscess with K. pneumoniae ST1 that did not carry a carbapenemase gene, but did carry blaDHA-1, blaOXA-1, and blaSHV-1. In this study, we report the first cases of blaNDM-carrying pathogens in the Philippines and add to the growing evidence of the worldwide spread of ST273 and NDM-7, a more efficient carbapenem hydrolyzer than NDM-1.
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, Baylor College of Medicine , Houston, Texas.|2 Department of Molecular Virology and Microbiology, Baylor College of Medicine , Houston, Texas.
authors.forename: Andrew
authors.initials: A
authors.lastname: Chou
authors.affiliation: 3 Research and Biotechnology Group, St. Luke's Medical Center , Quezon City, Philippines .
authors.forename: Marylette
authors.initials: M
authors.lastname: Roa
authors.affiliation: 4 Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine , Houston, Texas.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Evangelista
authors.affiliation: 3 Research and Biotechnology Group, St. Luke's Medical Center , Quezon City, Philippines .
authors.forename: Arielle Kae
authors.initials: AK
authors.lastname: Sulit
authors.affiliation: 5 Pathology Institute, St. Luke's Medical Center , Quezon City, Philippines .
authors.forename: Evelina
authors.initials: E
authors.lastname: Lagamayo
authors.affiliation: 3 Research and Biotechnology Group, St. Luke's Medical Center , Quezon City, Philippines .
authors.forename: Brian C
authors.initials: BC
authors.lastname: Torres
authors.affiliation: 3 Research and Biotechnology Group, St. Luke's Medical Center , Quezon City, Philippines .|6 Tahoe Research Initiative , Incline Village, Nevada.
authors.forename: David C
authors.initials: DC
authors.lastname: Klinzing
authors.affiliation: 3 Research and Biotechnology Group, St. Luke's Medical Center , Quezon City, Philippines .
authors.forename: Maria Luisa G
authors.initials: ML
authors.lastname: Daroy
authors.affiliation: 5 Pathology Institute, St. Luke's Medical Center , Quezon City, Philippines .|7 Infection Control Service, St. Luke's Medical Center , Quezon City, Philippines .
authors.forename: Josephine
authors.initials: J
authors.lastname: Navoa-Ng
authors.affiliation: 4 Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine , Houston, Texas.
authors.forename: Richard
authors.initials: R
authors.lastname: Sucgang
authors.affiliation: 2 Department of Molecular Virology and Microbiology, Baylor College of Medicine , Houston, Texas.|4 Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine , Houston, Texas.|8 Department of Pharmacology, Baylor College of Medicine , Houston, Texas.
authors.forename: Lynn
authors.initials: L
authors.lastname: Zechiedrich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D015780:Carbapenems / Q000494:pharmacology; D005260:Female; D015870:Gene Expression; D005838:Genotype; D006761:Hospitals; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D060885:Multiplex Polymerase Chain Reaction; D010679:Philippines / Q000453:epidemiology; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism*; D055815:Young Adult; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Enterobacteriaceae; carbapenem resistant; carbapenemase; metallo-beta-lactamase; molecular epidemiology; whole genome sequencing