Features of infections due to klebsiella pneumoniae carbapenemase-producing escherichia coli: Emergence of sequence type 131

Young Ah Kim, Zubair A. Qureshi, Jennifer M. Adams-Haduch, Yoon Soo Park, Kathleen A. Shutt, Yohei Doi

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background. Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae has become endemic in many US hospitals. On the other hand, KPC-producing Escherichia coli remains rare. Methods. We studied infection or colonization due to KPC-producing E. coli identified at our hospital between September 2008 and February 2011. A case-control study was conducted to document clinical features associated with this organism. Susceptibility testing, sequencing of-lactamase genes, pulsed-field gel electrophoresis, multilocus sequence typing, and plasmid analysis were performed for characterization of the isolates.Results.Thirteen patients with KPC-producing E. coli were identified. The patients had multiple comorbid conditions and were in hospital for variable periods of time before KPC-producing E. coli was identified. The presence of liver diseases was independently associated with recovery of KPC-producing E. coli when compared with extended-spectrum-lactamase-producing E. coli. The isolates showed variable susceptibility to carbapenems. Seven isolates belonged to sequence type (ST) 131, which is the international epidemic, multidrug-resistant clone, but their plasmid profiles were diverse. KPC-producing organisms other than E. coli were isolated within 1 month from 5 of the patients. The KPC-encoding plasmids were highly related in 3 of them, suggesting the occurrence of their interspecies transfer. Conclusions. KPC-producing E. coli infections occur in severely ill patients who are admitted to the hospital. Acquisition of the KPC-encoding plasmids by the ST 131 clone, reported here for the first time to our knowledge in the United States, seems to represent multiple independent events. These plasmids are often shared between E. coli and other species.

Original languageEnglish
Pages (from-to)224-231
Number of pages8
JournalClinical Infectious Diseases
Volume55
Issue number2
DOIs
Publication statusPublished - 15-07-2012

Fingerprint

Klebsiella pneumoniae
Escherichia coli
Infection
Plasmids
carbapenemase
Clone Cells
Multilocus Sequence Typing
Escherichia coli Infections
Carbapenems
Pulsed Field Gel Electrophoresis
Case-Control Studies
Liver Diseases

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Kim, Young Ah ; Qureshi, Zubair A. ; Adams-Haduch, Jennifer M. ; Park, Yoon Soo ; Shutt, Kathleen A. ; Doi, Yohei. / Features of infections due to klebsiella pneumoniae carbapenemase-producing escherichia coli : Emergence of sequence type 131. In: Clinical Infectious Diseases. 2012 ; Vol. 55, No. 2. pp. 224-231.
@article{d22c8d139a0c45148e5151e4ed5b7b00,
title = "Features of infections due to klebsiella pneumoniae carbapenemase-producing escherichia coli: Emergence of sequence type 131",
abstract = "Background. Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae has become endemic in many US hospitals. On the other hand, KPC-producing Escherichia coli remains rare. Methods. We studied infection or colonization due to KPC-producing E. coli identified at our hospital between September 2008 and February 2011. A case-control study was conducted to document clinical features associated with this organism. Susceptibility testing, sequencing of-lactamase genes, pulsed-field gel electrophoresis, multilocus sequence typing, and plasmid analysis were performed for characterization of the isolates.Results.Thirteen patients with KPC-producing E. coli were identified. The patients had multiple comorbid conditions and were in hospital for variable periods of time before KPC-producing E. coli was identified. The presence of liver diseases was independently associated with recovery of KPC-producing E. coli when compared with extended-spectrum-lactamase-producing E. coli. The isolates showed variable susceptibility to carbapenems. Seven isolates belonged to sequence type (ST) 131, which is the international epidemic, multidrug-resistant clone, but their plasmid profiles were diverse. KPC-producing organisms other than E. coli were isolated within 1 month from 5 of the patients. The KPC-encoding plasmids were highly related in 3 of them, suggesting the occurrence of their interspecies transfer. Conclusions. KPC-producing E. coli infections occur in severely ill patients who are admitted to the hospital. Acquisition of the KPC-encoding plasmids by the ST 131 clone, reported here for the first time to our knowledge in the United States, seems to represent multiple independent events. These plasmids are often shared between E. coli and other species.",
author = "Kim, {Young Ah} and Qureshi, {Zubair A.} and Adams-Haduch, {Jennifer M.} and Park, {Yoon Soo} and Shutt, {Kathleen A.} and Yohei Doi",
year = "2012",
month = "7",
day = "15",
doi = "10.1093/cid/cis387",
language = "English",
volume = "55",
pages = "224--231",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "2",

}

Features of infections due to klebsiella pneumoniae carbapenemase-producing escherichia coli : Emergence of sequence type 131. / Kim, Young Ah; Qureshi, Zubair A.; Adams-Haduch, Jennifer M.; Park, Yoon Soo; Shutt, Kathleen A.; Doi, Yohei.

In: Clinical Infectious Diseases, Vol. 55, No. 2, 15.07.2012, p. 224-231.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Features of infections due to klebsiella pneumoniae carbapenemase-producing escherichia coli

T2 - Emergence of sequence type 131

AU - Kim, Young Ah

AU - Qureshi, Zubair A.

AU - Adams-Haduch, Jennifer M.

AU - Park, Yoon Soo

AU - Shutt, Kathleen A.

AU - Doi, Yohei

PY - 2012/7/15

Y1 - 2012/7/15

N2 - Background. Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae has become endemic in many US hospitals. On the other hand, KPC-producing Escherichia coli remains rare. Methods. We studied infection or colonization due to KPC-producing E. coli identified at our hospital between September 2008 and February 2011. A case-control study was conducted to document clinical features associated with this organism. Susceptibility testing, sequencing of-lactamase genes, pulsed-field gel electrophoresis, multilocus sequence typing, and plasmid analysis were performed for characterization of the isolates.Results.Thirteen patients with KPC-producing E. coli were identified. The patients had multiple comorbid conditions and were in hospital for variable periods of time before KPC-producing E. coli was identified. The presence of liver diseases was independently associated with recovery of KPC-producing E. coli when compared with extended-spectrum-lactamase-producing E. coli. The isolates showed variable susceptibility to carbapenems. Seven isolates belonged to sequence type (ST) 131, which is the international epidemic, multidrug-resistant clone, but their plasmid profiles were diverse. KPC-producing organisms other than E. coli were isolated within 1 month from 5 of the patients. The KPC-encoding plasmids were highly related in 3 of them, suggesting the occurrence of their interspecies transfer. Conclusions. KPC-producing E. coli infections occur in severely ill patients who are admitted to the hospital. Acquisition of the KPC-encoding plasmids by the ST 131 clone, reported here for the first time to our knowledge in the United States, seems to represent multiple independent events. These plasmids are often shared between E. coli and other species.

AB - Background. Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae has become endemic in many US hospitals. On the other hand, KPC-producing Escherichia coli remains rare. Methods. We studied infection or colonization due to KPC-producing E. coli identified at our hospital between September 2008 and February 2011. A case-control study was conducted to document clinical features associated with this organism. Susceptibility testing, sequencing of-lactamase genes, pulsed-field gel electrophoresis, multilocus sequence typing, and plasmid analysis were performed for characterization of the isolates.Results.Thirteen patients with KPC-producing E. coli were identified. The patients had multiple comorbid conditions and were in hospital for variable periods of time before KPC-producing E. coli was identified. The presence of liver diseases was independently associated with recovery of KPC-producing E. coli when compared with extended-spectrum-lactamase-producing E. coli. The isolates showed variable susceptibility to carbapenems. Seven isolates belonged to sequence type (ST) 131, which is the international epidemic, multidrug-resistant clone, but their plasmid profiles were diverse. KPC-producing organisms other than E. coli were isolated within 1 month from 5 of the patients. The KPC-encoding plasmids were highly related in 3 of them, suggesting the occurrence of their interspecies transfer. Conclusions. KPC-producing E. coli infections occur in severely ill patients who are admitted to the hospital. Acquisition of the KPC-encoding plasmids by the ST 131 clone, reported here for the first time to our knowledge in the United States, seems to represent multiple independent events. These plasmids are often shared between E. coli and other species.

UR - http://www.scopus.com/inward/record.url?scp=84864136493&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864136493&partnerID=8YFLogxK

U2 - 10.1093/cid/cis387

DO - 10.1093/cid/cis387

M3 - Article

C2 - 22491340

AN - SCOPUS:84864136493

VL - 55

SP - 224

EP - 231

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 2

ER -