High prevalence of CTX-M-15-producing Klebsiella pneumoniae isolates in Asian countries: diverse clones and clonal dissemination

• Published in: International journal of antimicrobial agents Vol. 38; no. 2; pp. 160 - 163
• Main Authors: Lee, Mi Young, Ko, Kwan Soo, Kang, Cheol-In, Chung, Doo Ryeon, Peck, Kyong Ran, Song, Jae-Hoon
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.08.2011; Elsevier
• Subjects: Antibiotics. Antiinfectious agents. Antiparasitic agents; Asia - epidemiology; beta-lactamase; beta-Lactamases - biosynthesis; beta-Lactamases - genetics; Biological and medical sciences; clones; DNA, Bacterial - genetics; Extended-spectrum β-lactamase; genes; Genotype; Humans; Infectious Disease; Klebsiella Infections - epidemiology; Klebsiella Infections - microbiology; Klebsiella pneumoniae; Klebsiella pneumoniae - classification; Klebsiella pneumoniae - enzymology; Klebsiella pneumoniae - genetics; Klebsiella pneumoniae - isolation & purification; Medical sciences; Molecular Epidemiology; Multilocus Sequence Typing; patients; Pharmacology. Drug treatments; plasmids; Plasmids - analysis; pneumonia; Prevalence; Replicon; Taiwan; Asia; Extended-spectrum β-lactamase; Klebsiella pneumoniae; Replicon; Clonality; Asiatic; Prevalence; Countries; Epidemiology; Dissemination; Bacteria; Isolate; Enterobacteriaceae; Clone
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2011.03.020

Abstract The characteristics of 218 Klebsiella pneumoniae isolates from patients with hospital-acquired pneumonia in nine Asian countries were investigated. In total, 92 isolates (42.2%) produced extended-spectrum β-lactamases (ESBLs), amongst which 67 (72.8%) possessed CTX-M ESBL genes; CTX-M-15 was the major ESBL (55 isolates; 59.8%). Multilocus sequence typing (MLST) and plasmid replicon typing were performed to investigate the genetic backgrounds of the 55 CTX-M-15-producing K. pneumoniae isolates. Twenty-five sequence types (STs) were identified. Clonal complex 11 (CC11) including ST11 was the most prevalent clone (20 isolates; 36.4%) and was distributed in all Asian countries except Taiwan. ST15 was the next most frequently identified clone (8 isolates; 14.5%). An IncFIIA-type plasmid was predominantly associated with blaCTX-M-15 (45 isolates; 81.8%). However, another plasmid type (IncA/C) was also identified and replicon types of seven isolates could not be determined. The high prevalence of CTX-M-15 amongst K. pneumoniae isolates in Asian countries may be due both to the acquisition of plasmids carrying blaCTX-M-15 and the spread of certain clones such as ST11 and ST15.