Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina

Autores
Nicola, Federico; Cejas, Daniela; Gonzalez Espinosa, Francisco Eduardo; Relloso, Silvia; Herrera, Fabián; Bonvehí, Pablo; Smayevsky, Jorgelina; Figueroa Espinosa, Roque Arnulfo; Gutkind, Gabriel Osvaldo; Radice, Marcela Alejandra
Año de publicación
2022
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
We describe an outbreak of Klebsiella pneumoniae sequence type 11 (ST11) producing KPC variants resistant to ceftazidime-avibactam. Six patients hospitalized in the intensive care unit (mostly due to critical COVID pneumonia) presented infection or colonization by this bacterium. They had several comorbidities and required mechanical ventilation, central venous catheters, and urinary catheters. All 6 patients had a history of fecal colonization with KPC-producing Enterobacterales (KPC-E). Three of them had previous episodes of infection with ceftazidime-avibactam-susceptible KPC-producing K. pneumoniae, which were treated with ceftazidime-avibactam. Several phenotypic methods failed to detect carbapenemase production in these 6 ceftazidime-avibactam-resistant isolates, and they showed in vitro susceptibility to imipenem and meropenem. All of them rendered positive results for blaKPC by PCR, and amplicon sequencing identified blaKPC-31 variant in 5 isolates and a novel variant, named blaKPC-115, in the other. Moreover, matrix-assisted laser desorption ionization–time of flight mass spectrometry was able to detect KPC in all isolates. Ceftazidime-avibactam-resistant isolates, as well as those recovered from previous infection episodes (KPC-3-producing K. pneumoniae, ceftazidime-avibactam susceptible), displayed a unique pulse type and belonged to ST11. Based on whole-genome sequencing results of selected isolates, less than 7 single-nucleotide polymorphisms were identified among them, which was indicative of the presence of a unique clone. Both in vivo selection and horizontal transmission seemed to have occurred in our hospital. Detection of these strains is challenging for the laboratory. History of previous KPC-E infections or colonization and systematic testing for resistance to ceftazidime-avibactam might help raise awareness of this possibility.
Fil: Nicola, Federico. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Cejas, Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina
Fil: Gonzalez Espinosa, Francisco Eduardo. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Relloso, Silvia. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Herrera, Fabián. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina
Fil: Bonvehí, Pablo. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Smayevsky, Jorgelina. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Figueroa Espinosa, Roque Arnulfo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina
Fil: Gutkind, Gabriel Osvaldo. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Radice, Marcela Alejandra. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Materia
CEFTAZIDIME/AVIBACTAM
KPC MUTANTS
KPC-31
KPC-115
COVID-19
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/217287
Acceder
id CONICETDig_ccb25934de2068b8422cd51ac7847924
oai_identifier_str oai:ri.conicet.gov.ar:11336/217287
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in ArgentinaNicola, FedericoCejas, DanielaGonzalez Espinosa, Francisco EduardoRelloso, SilviaHerrera, FabiánBonvehí, PabloSmayevsky, JorgelinaFigueroa Espinosa, Roque ArnulfoGutkind, Gabriel OsvaldoRadice, Marcela AlejandraCEFTAZIDIME/AVIBACTAMKPC MUTANTSKPC-31KPC-115COVID-19https://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3We describe an outbreak of Klebsiella pneumoniae sequence type 11 (ST11) producing KPC variants resistant to ceftazidime-avibactam. Six patients hospitalized in the intensive care unit (mostly due to critical COVID pneumonia) presented infection or colonization by this bacterium. They had several comorbidities and required mechanical ventilation, central venous catheters, and urinary catheters. All 6 patients had a history of fecal colonization with KPC-producing Enterobacterales (KPC-E). Three of them had previous episodes of infection with ceftazidime-avibactam-susceptible KPC-producing K. pneumoniae, which were treated with ceftazidime-avibactam. Several phenotypic methods failed to detect carbapenemase production in these 6 ceftazidime-avibactam-resistant isolates, and they showed in vitro susceptibility to imipenem and meropenem. All of them rendered positive results for blaKPC by PCR, and amplicon sequencing identified blaKPC-31 variant in 5 isolates and a novel variant, named blaKPC-115, in the other. Moreover, matrix-assisted laser desorption ionization–time of flight mass spectrometry was able to detect KPC in all isolates. Ceftazidime-avibactam-resistant isolates, as well as those recovered from previous infection episodes (KPC-3-producing K. pneumoniae, ceftazidime-avibactam susceptible), displayed a unique pulse type and belonged to ST11. Based on whole-genome sequencing results of selected isolates, less than 7 single-nucleotide polymorphisms were identified among them, which was indicative of the presence of a unique clone. Both in vivo selection and horizontal transmission seemed to have occurred in our hospital. Detection of these strains is challenging for the laboratory. History of previous KPC-E infections or colonization and systematic testing for resistance to ceftazidime-avibactam might help raise awareness of this possibility.Fil: Nicola, Federico. Centro de Educación Medica E Invest.clinicas; ArgentinaFil: Cejas, Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); ArgentinaFil: Gonzalez Espinosa, Francisco Eduardo. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Relloso, Silvia. Centro de Educación Medica E Invest.clinicas; ArgentinaFil: Herrera, Fabián. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; ArgentinaFil: Bonvehí, Pablo. Centro de Educación Medica E Invest.clinicas; ArgentinaFil: Smayevsky, Jorgelina. Centro de Educación Medica E Invest.clinicas; ArgentinaFil: Figueroa Espinosa, Roque Arnulfo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); ArgentinaFil: Gutkind, Gabriel Osvaldo. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Radice, Marcela Alejandra. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaAmerican Society for Microbiology2022-11info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/217287Nicola, Federico; Cejas, Daniela; Gonzalez Espinosa, Francisco Eduardo; Relloso, Silvia; Herrera, Fabián; et al.; Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina; American Society for Microbiology; Microbiology Spectrum; 10; 6; 11-2022; 1-72165-0497CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://journals.asm.org/doi/full/10.1128/spectrum.03733-22info:eu-repo/semantics/altIdentifier/doi/10.1128/spectrum.03733-22info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:33:10Zoai:ri.conicet.gov.ar:11336/217287instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:33:11.2CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina
title Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina
spellingShingle Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina
Nicola, Federico
CEFTAZIDIME/AVIBACTAM
KPC MUTANTS
KPC-31
KPC-115
COVID-19
title_short Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina
title_full Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina
title_fullStr Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina
title_full_unstemmed Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina
title_sort Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina
dc.creator.none.fl_str_mv Nicola, Federico
Cejas, Daniela
Gonzalez Espinosa, Francisco Eduardo
Relloso, Silvia
Herrera, Fabián
Bonvehí, Pablo
Smayevsky, Jorgelina
Figueroa Espinosa, Roque Arnulfo
Gutkind, Gabriel Osvaldo
Radice, Marcela Alejandra
author Nicola, Federico
author_facet Nicola, Federico
Cejas, Daniela
Gonzalez Espinosa, Francisco Eduardo
Relloso, Silvia
Herrera, Fabián
Bonvehí, Pablo
Smayevsky, Jorgelina
Figueroa Espinosa, Roque Arnulfo
Gutkind, Gabriel Osvaldo
Radice, Marcela Alejandra
author_role author
author2 Cejas, Daniela
Gonzalez Espinosa, Francisco Eduardo
Relloso, Silvia
Herrera, Fabián
Bonvehí, Pablo
Smayevsky, Jorgelina
Figueroa Espinosa, Roque Arnulfo
Gutkind, Gabriel Osvaldo
Radice, Marcela Alejandra
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv CEFTAZIDIME/AVIBACTAM
KPC MUTANTS
KPC-31
KPC-115
COVID-19
topic CEFTAZIDIME/AVIBACTAM
KPC MUTANTS
KPC-31
KPC-115
COVID-19
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv We describe an outbreak of Klebsiella pneumoniae sequence type 11 (ST11) producing KPC variants resistant to ceftazidime-avibactam. Six patients hospitalized in the intensive care unit (mostly due to critical COVID pneumonia) presented infection or colonization by this bacterium. They had several comorbidities and required mechanical ventilation, central venous catheters, and urinary catheters. All 6 patients had a history of fecal colonization with KPC-producing Enterobacterales (KPC-E). Three of them had previous episodes of infection with ceftazidime-avibactam-susceptible KPC-producing K. pneumoniae, which were treated with ceftazidime-avibactam. Several phenotypic methods failed to detect carbapenemase production in these 6 ceftazidime-avibactam-resistant isolates, and they showed in vitro susceptibility to imipenem and meropenem. All of them rendered positive results for blaKPC by PCR, and amplicon sequencing identified blaKPC-31 variant in 5 isolates and a novel variant, named blaKPC-115, in the other. Moreover, matrix-assisted laser desorption ionization–time of flight mass spectrometry was able to detect KPC in all isolates. Ceftazidime-avibactam-resistant isolates, as well as those recovered from previous infection episodes (KPC-3-producing K. pneumoniae, ceftazidime-avibactam susceptible), displayed a unique pulse type and belonged to ST11. Based on whole-genome sequencing results of selected isolates, less than 7 single-nucleotide polymorphisms were identified among them, which was indicative of the presence of a unique clone. Both in vivo selection and horizontal transmission seemed to have occurred in our hospital. Detection of these strains is challenging for the laboratory. History of previous KPC-E infections or colonization and systematic testing for resistance to ceftazidime-avibactam might help raise awareness of this possibility.
Fil: Nicola, Federico. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Cejas, Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina
Fil: Gonzalez Espinosa, Francisco Eduardo. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Relloso, Silvia. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Herrera, Fabián. Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno"; Argentina
Fil: Bonvehí, Pablo. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Smayevsky, Jorgelina. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Figueroa Espinosa, Roque Arnulfo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina
Fil: Gutkind, Gabriel Osvaldo. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Radice, Marcela Alejandra. Universidad de Buenos Aires. Facultad de Farmacia y BioquÍmica. Instituto de Investigaciones En Bacteriología y Virología Molecular (IBaViM); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
description We describe an outbreak of Klebsiella pneumoniae sequence type 11 (ST11) producing KPC variants resistant to ceftazidime-avibactam. Six patients hospitalized in the intensive care unit (mostly due to critical COVID pneumonia) presented infection or colonization by this bacterium. They had several comorbidities and required mechanical ventilation, central venous catheters, and urinary catheters. All 6 patients had a history of fecal colonization with KPC-producing Enterobacterales (KPC-E). Three of them had previous episodes of infection with ceftazidime-avibactam-susceptible KPC-producing K. pneumoniae, which were treated with ceftazidime-avibactam. Several phenotypic methods failed to detect carbapenemase production in these 6 ceftazidime-avibactam-resistant isolates, and they showed in vitro susceptibility to imipenem and meropenem. All of them rendered positive results for blaKPC by PCR, and amplicon sequencing identified blaKPC-31 variant in 5 isolates and a novel variant, named blaKPC-115, in the other. Moreover, matrix-assisted laser desorption ionization–time of flight mass spectrometry was able to detect KPC in all isolates. Ceftazidime-avibactam-resistant isolates, as well as those recovered from previous infection episodes (KPC-3-producing K. pneumoniae, ceftazidime-avibactam susceptible), displayed a unique pulse type and belonged to ST11. Based on whole-genome sequencing results of selected isolates, less than 7 single-nucleotide polymorphisms were identified among them, which was indicative of the presence of a unique clone. Both in vivo selection and horizontal transmission seemed to have occurred in our hospital. Detection of these strains is challenging for the laboratory. History of previous KPC-E infections or colonization and systematic testing for resistance to ceftazidime-avibactam might help raise awareness of this possibility.
publishDate 2022
dc.date.none.fl_str_mv 2022-11
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/217287
Nicola, Federico; Cejas, Daniela; Gonzalez Espinosa, Francisco Eduardo; Relloso, Silvia; Herrera, Fabián; et al.; Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina; American Society for Microbiology; Microbiology Spectrum; 10; 6; 11-2022; 1-7
2165-0497
CONICET Digital
CONICET
url http://hdl.handle.net/11336/217287
identifier_str_mv Nicola, Federico; Cejas, Daniela; Gonzalez Espinosa, Francisco Eduardo; Relloso, Silvia; Herrera, Fabián; et al.; Outbreak of Klebsiella pneumoniae ST11 Resistant to Ceftazidime-Avibactam Producing KPC-31 and the Novel Variant KPC-115 during COVID-19 Pandemic in Argentina; American Society for Microbiology; Microbiology Spectrum; 10; 6; 11-2022; 1-7
2165-0497
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://journals.asm.org/doi/full/10.1128/spectrum.03733-22
info:eu-repo/semantics/altIdentifier/doi/10.1128/spectrum.03733-22
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv American Society for Microbiology
publisher.none.fl_str_mv American Society for Microbiology
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1844613017671565312
score 13.070432

Publicaciones similares