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Published in: Antimicrobial Resistance & Infection Control 1/2016

Open Access 01-12-2016 | Short report

Emergence of serotype K1 Klebsiella pneumoniae ST23 strains co-producing the plasmid-mediated AmpC beta-lactamase DHA-1 and an extended-spectrum beta-lactamase in Korea

Authors: Hae Suk Cheong, Doo Ryeon Chung, Chaeyoeng Lee, So Hyun Kim, Cheol-In Kang, Kyong Ran Peck, Jae-Hoon Song

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2016

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Abstract

Background

Serotype K1 Klebsiella pneumoniae has emerged as an important community pathogen causing various infections, including liver abscesses. Although serotype K1 K. pneumoniae community isolates have been reported as susceptible to most classes of antimicrobial agents, a few cases of infection caused by extended-spectrum beta-lactamase (ESBL)-producing serotype K1 K. pneumoniae have recently been reported in Asian countries. We identified three ESBL-producing strains of serotype K1 K. pneumoniae and conducted a molecular characterization of their drug resistance.

Methods

Three ESBL-producing serotype K1 K. pneumoniae ST23 strains were identified from strains in the Asian Bacterial Bank. Antimicrobial susceptibility testing was performed using the broth microdilution method, and ESBL production was tested by the double-disk synergy test and a confirmatory test. PCR was performed to detect the genes for plasmid-mediated ESBL and AmpC beta-lactamases.

Results

All three strains were resistant to cefotaxime, ceftazidime, and piperacillin/tazobactam, and all were determined to be ESBL-producers. No known ESBL genes, including bla SHV, bla TEM, bla CTX-M, bla GES, bla PER, and bla VEB, were detected among the three strains. Of all plasmid-mediated AmpC beta-lactamase (PAB) genes, including bla DHA-1, bla CMY, bla FOX, and bla MOX, the bla DHA-1 gene was detected in two of the strains. The PFGE patterns revealed that the two isolates carrying bla DHA-1 were closely related (84% similarity).

Conclusions

No ESBL genes were detected among three ESBL-producing serotype K1 K. pneumoniae ST23 strains. Two strains contained the PAB gene bla DHA-1. The emergence of resistant strains of community-origin serotype K1 K. pneumoniae has important implications for effective treatment and infection control practices.
Literature
1.
go back to reference Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL, Chang SC. Klebsiella pneumoniae genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis. 2007;45(3):284–93.CrossRefPubMed Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL, Chang SC. Klebsiella pneumoniae genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis. 2007;45(3):284–93.CrossRefPubMed
2.
go back to reference Chung DR, Lee SS, Lee HR, et al. Emerging invasive liver abscess caused by K1 serotype klebsiella pneumoniae in korea. J Infect. 2007;54(6):578–83.CrossRefPubMed Chung DR, Lee SS, Lee HR, et al. Emerging invasive liver abscess caused by K1 serotype klebsiella pneumoniae in korea. J Infect. 2007;54(6):578–83.CrossRefPubMed
3.
go back to reference Liu YM, Li BB, Zhang YY, et al. Clinical and molecular characteristics of emerging hypervirulent klebsiella pneumoniae bloodstream infections in mainland china. Antimicrob Agents Chemother. 2014;58(9):5379–85.CrossRefPubMedPubMedCentral Liu YM, Li BB, Zhang YY, et al. Clinical and molecular characteristics of emerging hypervirulent klebsiella pneumoniae bloodstream infections in mainland china. Antimicrob Agents Chemother. 2014;58(9):5379–85.CrossRefPubMedPubMedCentral
4.
go back to reference Chung DR, Lee HR, Lee SS, et al. Evidence for clonal dissemination of the serotype K1 klebsiella pneumoniae strain causing invasive liver abscesses in korea. J Clin Microbiol. 2008;46(12):4061–3.CrossRefPubMedPubMedCentral Chung DR, Lee HR, Lee SS, et al. Evidence for clonal dissemination of the serotype K1 klebsiella pneumoniae strain causing invasive liver abscesses in korea. J Clin Microbiol. 2008;46(12):4061–3.CrossRefPubMedPubMedCentral
5.
go back to reference Chung DR, Park MH, Kim SH, et al. Prevalence and molecular characterization of serotype K1 klebsiella pneumoniae strains from various clinical specimen sources in 11 asian countries. J Infect. 2012;64(6):622–5.CrossRefPubMed Chung DR, Park MH, Kim SH, et al. Prevalence and molecular characterization of serotype K1 klebsiella pneumoniae strains from various clinical specimen sources in 11 asian countries. J Infect. 2012;64(6):622–5.CrossRefPubMed
6.
go back to reference Su SC, Siu LK, Ma L, et al. Community-acquired liver abscess caused by serotype K1 klebsiella pneumoniae with CTX-M-15-type extended-spectrum beta-lactamase. Antimicrob Agents Chemother. 2008;52(2):804–5.CrossRefPubMed Su SC, Siu LK, Ma L, et al. Community-acquired liver abscess caused by serotype K1 klebsiella pneumoniae with CTX-M-15-type extended-spectrum beta-lactamase. Antimicrob Agents Chemother. 2008;52(2):804–5.CrossRefPubMed
7.
go back to reference Nagano N, Cordevant C, Nagano Y. Upper and lower urinary tract infection caused by klebsiella pneumoniae serotype K2 and CTX-M-15 beta-lactamase-producing serotype K1: a case report and characterization of serum killing resistance. J Med Microbiol. 2008;57(Pt 1):121–4.CrossRefPubMed Nagano N, Cordevant C, Nagano Y. Upper and lower urinary tract infection caused by klebsiella pneumoniae serotype K2 and CTX-M-15 beta-lactamase-producing serotype K1: a case report and characterization of serum killing resistance. J Med Microbiol. 2008;57(Pt 1):121–4.CrossRefPubMed
8.
go back to reference Clinical and Laboratory Standards Institute(CLSI). Performance standards for antimicrobial susceptibility testing, 20th informational supplement M100-S22. Wayne: CLSI; 2010. Clinical and Laboratory Standards Institute(CLSI). Performance standards for antimicrobial susceptibility testing, 20th informational supplement M100-S22. Wayne: CLSI; 2010.
9.
go back to reference Struve C, Bojer M, Nielsen EM, Hansen DS, Krogfelt KA. Investigation of the putative virulence gene magA in a worldwide collection of 495 klebsiella isolates: magA is restricted to the gene cluster of klebsiella pneumoniae capsule serotype K1. J Med Microbiol. 2005;54(Pt 11):1111–3.CrossRefPubMed Struve C, Bojer M, Nielsen EM, Hansen DS, Krogfelt KA. Investigation of the putative virulence gene magA in a worldwide collection of 495 klebsiella isolates: magA is restricted to the gene cluster of klebsiella pneumoniae capsule serotype K1. J Med Microbiol. 2005;54(Pt 11):1111–3.CrossRefPubMed
10.
go back to reference Diancourt L, Passet V, Verhoef J, Grimont PA, Brisse S. Multilocus sequence typing of klebsiella pneumoniae nosocomial isolates. J Clin Microbiol. 2005;43(8):4178–82.CrossRefPubMedPubMedCentral Diancourt L, Passet V, Verhoef J, Grimont PA, Brisse S. Multilocus sequence typing of klebsiella pneumoniae nosocomial isolates. J Clin Microbiol. 2005;43(8):4178–82.CrossRefPubMedPubMedCentral
11.
go back to reference Qi Y, Wei Z, Li L, et al. Detection of a common plasmid carrying blaKPC-2 in enterobacteriaceae isolates from distinct cities in china. Microb Drug Resist. 2010;16(4):297–301.CrossRefPubMed Qi Y, Wei Z, Li L, et al. Detection of a common plasmid carrying blaKPC-2 in enterobacteriaceae isolates from distinct cities in china. Microb Drug Resist. 2010;16(4):297–301.CrossRefPubMed
12.
go back to reference Cheong HS, Ko KS, Kang CI, Chung DR, Peck KR, Song JH. Clinical significance of infections caused by extended-spectrum beta-lactamase-producing enterobacteriaceae blood isolates with inducible AmpC beta-lactamase. Microb Drug Resist. 2012;18(4):446–52.CrossRefPubMed Cheong HS, Ko KS, Kang CI, Chung DR, Peck KR, Song JH. Clinical significance of infections caused by extended-spectrum beta-lactamase-producing enterobacteriaceae blood isolates with inducible AmpC beta-lactamase. Microb Drug Resist. 2012;18(4):446–52.CrossRefPubMed
13.
go back to reference Cheong HS, Ko KS, Kang CI, Chung DR, Peck KR, Song JH. Clinical significance of infections caused by plasmid-mediated AmpC beta-lactamases and extended-spectrum beta-lactamase-producing escherichia coli. Infection. 2013;41(1):287–91.CrossRefPubMed Cheong HS, Ko KS, Kang CI, Chung DR, Peck KR, Song JH. Clinical significance of infections caused by plasmid-mediated AmpC beta-lactamases and extended-spectrum beta-lactamase-producing escherichia coli. Infection. 2013;41(1):287–91.CrossRefPubMed
14.
go back to reference Denisuik AJ, Lagace-Wiens PR, Pitout JD, et al. Molecular epidemiology of extended-spectrum beta-lactamase-, AmpC beta-lactamase- and carbapenemase-producing escherichia coli and klebsiella pneumoniae isolated from canadian hospitals over a 5 year period: CANWARD 2007–11. J Antimicrob Chemother. 2013;68 Suppl 1:i57–65.CrossRefPubMed Denisuik AJ, Lagace-Wiens PR, Pitout JD, et al. Molecular epidemiology of extended-spectrum beta-lactamase-, AmpC beta-lactamase- and carbapenemase-producing escherichia coli and klebsiella pneumoniae isolated from canadian hospitals over a 5 year period: CANWARD 2007–11. J Antimicrob Chemother. 2013;68 Suppl 1:i57–65.CrossRefPubMed
15.
go back to reference Lee CH, Su LH, Li CC, Chien CC, Tang YF, Liu JW. Microbiologic and clinical implications of bacteremia due to extended-spectrum-beta-lactamase-producing klebsiella pneumoniae with or without plasmid-mediated AmpC beta-lactamase DHA-1. Antimicrob Agents Chemother. 2010;54(12):5395–8.CrossRefPubMedPubMedCentral Lee CH, Su LH, Li CC, Chien CC, Tang YF, Liu JW. Microbiologic and clinical implications of bacteremia due to extended-spectrum-beta-lactamase-producing klebsiella pneumoniae with or without plasmid-mediated AmpC beta-lactamase DHA-1. Antimicrob Agents Chemother. 2010;54(12):5395–8.CrossRefPubMedPubMedCentral
16.
go back to reference Yoon YK, Cheong HW, Pai H, et al. Molecular analysis of a prolonged spread of klebsiella pneumoniae co-producing DHA-1 and SHV-12 beta-lactamases. J Microbiol. 2011;49(3):363–8.CrossRefPubMed Yoon YK, Cheong HW, Pai H, et al. Molecular analysis of a prolonged spread of klebsiella pneumoniae co-producing DHA-1 and SHV-12 beta-lactamases. J Microbiol. 2011;49(3):363–8.CrossRefPubMed
17.
go back to reference Reuland EA, Halaby T, Hays JP, et al. Plasmid-mediated AmpC: prevalence in community-acquired isolates in Amsterdam, the Netherlands, and risk factors for carriage. PLoS One. 2015;10(1):e0113033.CrossRefPubMedPubMedCentral Reuland EA, Halaby T, Hays JP, et al. Plasmid-mediated AmpC: prevalence in community-acquired isolates in Amsterdam, the Netherlands, and risk factors for carriage. PLoS One. 2015;10(1):e0113033.CrossRefPubMedPubMedCentral
18.
go back to reference Matsumura Y, Tanaka M, Yamamoto M, et al. High prevalence of carbapenem resistance among plasmid-mediated AmpC beta-lactamase-producing klebsiella pneumoniae during outbreaks in liver transplantation units. Int J Antimicrob Agents. 2015;45(1):33–40.CrossRefPubMed Matsumura Y, Tanaka M, Yamamoto M, et al. High prevalence of carbapenem resistance among plasmid-mediated AmpC beta-lactamase-producing klebsiella pneumoniae during outbreaks in liver transplantation units. Int J Antimicrob Agents. 2015;45(1):33–40.CrossRefPubMed
Metadata
Title
Emergence of serotype K1 Klebsiella pneumoniae ST23 strains co-producing the plasmid-mediated AmpC beta-lactamase DHA-1 and an extended-spectrum beta-lactamase in Korea
Authors
Hae Suk Cheong
Doo Ryeon Chung
Chaeyoeng Lee
So Hyun Kim
Cheol-In Kang
Kyong Ran Peck
Jae-Hoon Song
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2016
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-016-0151-2

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