title: First Description of KPC-2-Producing Escherichia coli and ST15 OXA-48-Positive Klebsiella pneumoniae in Tunisia.
abstract: The aim of this study was to investigate the molecular features among Klebsiella pneumoniae and Escherichia coli strains showing a resistant/intermediate-resistant phenotype to ertapenem (R/IR-ERT), implicated in colonization/infection in patients of the Hematology and Graft Units of the National Bone Marrow Transplant Center of Tunisia (3-year period, 2011-2014). The major carbapenemase, extended-spectrum beta-lactamase, and plasmidic AmpC beta-lactamase genes were analyzed and characterized by PCR and sequencing. Genetic relatedness was determined by pulsed-field gel electrophoresis (PFGE) using XbaI and multilocus sequencing typing. The blaOXA-48and blaKPCcarbapenemase genes were detected among R/IR-ERT isolates. All R/IR-ERT K. pneumoniae strains (n = 19) had blaOXA-48gene, and 14/19 strains also harbored the blaCTX-M-15gene. Eight different PFGE patterns were detected among these K. pneumoniae isolates, and they showed eight different sequences types, ST11 and ST15 being the most prevalent ones. Two out of three R/IR-ERT E. coli isolates carried blaOXA-48and one coproduced the blaCTX-M-15gene. One E. coli strain, ascribed to the new sequence type ST5700, harbored the blaKPC-2gene. E. coli isolates were not clonally related and belonged to different sequence types (ST5700, ST227, and ST58). To our knowledge, this is the first report in Tunisia of either KPC-2 carbapenemase in E. coli or OXA-48 carbapenemase in K. pneumoniae of lineage ST15.
authors.affiliation: 1 Université de Carthage , Faculté des Sciences de Bizerte, 7021, Tunis, Tunisie.|2 Service des Laboratoires, Centre National de Greffe de Moelle Osseuse , Tunis, Tunisie.|3 Faculté de Médecine de Tunis, Université de Tunis El Manar , UR 12ES02, Tunis, Tunisie.
authors.forename: Farah
authors.initials: F
authors.lastname: Ben Tanfous
authors.affiliation: 4 Área de Bioquímica y Biología Molecular, Universidad de La Rioja , Logroño, Spain .
authors.forename: Carla Andrea
authors.initials: CA
authors.lastname: Alonso
authors.affiliation: 2 Service des Laboratoires, Centre National de Greffe de Moelle Osseuse , Tunis, Tunisie.|3 Faculté de Médecine de Tunis, Université de Tunis El Manar , UR 12ES02, Tunis, Tunisie.
authors.forename: Wafa
authors.initials: W
authors.lastname: Achour
authors.affiliation: 4 Área de Bioquímica y Biología Molecular, Universidad de La Rioja , Logroño, Spain .
authors.forename: Laura
authors.initials: L
authors.lastname: Ruiz-Ripa
authors.affiliation: 4 Área de Bioquímica y Biología Molecular, Universidad de La Rioja , Logroño, Spain .
authors.forename: Carmen
authors.initials: C
authors.lastname: Torres
authors.affiliation: 2 Service des Laboratoires, Centre National de Greffe de Moelle Osseuse , Tunis, Tunisie.|3 Faculté de Médecine de Tunis, Université de Tunis El Manar , UR 12ES02, Tunis, Tunisie.
authors.forename: Assia
authors.initials: A
authors.lastname: Ben Hassen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D004269:DNA, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000187:drug effects / Q000235:genetics*; D007710:Klebsiella Infections / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests / Q000379:methods; D058885:Multilocus Sequence Typing / Q000379:methods; D010957:Plasmids / Q000235:genetics; D014416:Tunisia; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Escherichia coli; KPC-2; Klebsiella pneumoniae; MLST; OXA-48; Tunisia