A carbapenem-resistant Klebsiella pneumoniae epidemic clone in Jerusalem: sequence type 512 carrying a plasmid encoding aac(6')-Ib.
Warburg, Gabriela 1; Hidalgo-Grass, Carlos 1; Partridge, Sally R. 2; Tolmasky, Marcelo E. 3; Temper, Violeta 1; Moses, Allon E. 1; Block, Colin 1; Strahilevitz, Jacob 1,*
[Article] Journal of Antimicrobial Chemotherapy. 67(4):898-901, April 2012.

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Objectives: We characterized distinctive features of a hypertransmissible carbapenem-resistant Klebsiella pneumoniae (CRKP) clone that emerged at Hadassah Hospital, Ein-Kerem, Jerusalem, Israel, in 2006.

Methods: Eleven CRKP isolated at Hadassah Hospital during 2005-09 were examined by antimicrobial susceptibility testing, PFGE and multilocus sequence typing (MLST). Plasmids were analysed by conjugation, restriction mapping, PCR and sequencing.

Results: Divergence from the national epidemic sequence type (ST) ST258 to ST512 was observed early on. Carbapenem resistance was conferred by blaKPC-3 carried on a plasmid apparently closely related to pKpQIL, also from Israel. This clone also carried a 15 kb plasmid, designated pAAC154, that carries a Tn1331 derivative containing the aac(6')-Ib gene. pAAC154 does not carry a blaKPC gene, but is similar to pS15, a plasmid from New York that carries blaKPC-2.

Conclusions: A single CRKP clone ST512 has spread efficiently in our region. In this clone, aac(6')-Ib, common in CRKP strains, is carried on a different plasmid from blaKPC-3.

(C) British Society for Antimicrobial Chemotherapy 2012. Published by Oxford University Press. All rights reserved.