TY - JOUR
T1 - Molecular epidemiology of KPC-producing Klebsiella pneumoniae from invasive infections in Italy: Increasing diversity with predominance of the ST512 clade II sublineage
AU - Giammanco, Anna
AU - Giani, Tommaso
AU - De Nittis, Rosella
AU - Piana, null
AU - D'Ancona, Fortunato
AU - Arena, Fabio
AU - Parisi, null
AU - Meledandri, null
AU - Mungiguerra, null
AU - D'Andrea, Marco Maria
AU - Restelli, null
AU - Conte, Viola
AU - Cavalcanti, null
AU - Pantosti, Annalisa
AU - Pini, null
AU - Sartor, null
AU - Dusi, null
AU - Milano, null
AU - Vincenzi, null
AU - Sartore, null
AU - Bona, null
AU - Bianchi, null
AU - Corradini, null
AU - Vincenzi, null
AU - Agrappi, null
AU - Sartor, null
AU - De Bernochi, null
AU - Chirillo, null
AU - Imbriani, null
AU - Gualdi, null
AU - Porcheddu, null
AU - Agrappi, null
AU - Pollini, null
AU - Pedna, null
AU - Aschbacher, null
AU - Dodi, null
AU - Rocchetti, null
AU - Cuccurullo, null
AU - Vailati, null
AU - Grandesso, null
AU - Santino, null
AU - Mencacci, Antonella
AU - Catania, Maria Rosaria
AU - Miragliotta, null
AU - Barbaro, null
AU - Rossolini, Gian Maria
AU - Moro, Maria Luisa
AU - Rossi, null
AU - Monaco, Monica
AU - Miragliotta, Angelo
AU - Lapiana, Francesco
PY - 2016
Y1 - 2016
N2 - Objectives: The spread of carbapenem-resistant Enterobacteriaceae (CRE) represents one of the most worrisome problems for clinical medicine worldwide. In Italy, the Antibiotic-Resistance-Istituto Superiore di Sanità surveillance network, in collaboration with the Committee for Antimicrobial Agents of the Italian Society of Clinical Microbiologists, promoted a study to investigate the carbapenem-resistance mechanisms, clonal relatedness and capsular typing of a recent collection of carbapenem-resistant Klebsiella pneumoniae (CR-KP). Methods: A total of 17 laboratories distributed across Italy collected all consecutive non-replicate CR-KP isolated from invasive infections during two different study periods (2011-12 and 2013). Carbapenemase genes were searched for by filter hybridization and confirmed by PCR and sequencing. KPC-producing K. pneumoniae (KPC-KP) were typed by PFGE and MLST. Capsular types were identified by wzi gene typing. Results: Of the collected K. pneumoniae isolates (n=461), the overall proportion of CR-KP was 36.2% (n=167). The majority (97%) of the CR-KP were positive for the blaKPC gene. Among the KPC-KP population, nine different STs were detected with the majority of isolates (94%) belonging to the clonal group (CG) 258. A subpopulation that belonged to ST512 and showed an identical PFGE profile represented the majority (57%) of KPC-KP strains, with a countrywide distribution. Capsular characterization showed the predominance of the wzi154, cps-2 capsular type (88.8% of all CG258 strains). ST258 strains were associated with both cps-1 and cps-2 capsular types, while ST512 was associated with cps-2 only. Conclusions: Although a trend to a polyclonal evolution of the Italian KPC-KP was noted, this study showed that the KPC-KP population remained largely oligoclonal with the wide diffusion of an ST512 lineage carrying cps-2 capsular type and producing the KPC-3 enzyme.
AB - Objectives: The spread of carbapenem-resistant Enterobacteriaceae (CRE) represents one of the most worrisome problems for clinical medicine worldwide. In Italy, the Antibiotic-Resistance-Istituto Superiore di Sanità surveillance network, in collaboration with the Committee for Antimicrobial Agents of the Italian Society of Clinical Microbiologists, promoted a study to investigate the carbapenem-resistance mechanisms, clonal relatedness and capsular typing of a recent collection of carbapenem-resistant Klebsiella pneumoniae (CR-KP). Methods: A total of 17 laboratories distributed across Italy collected all consecutive non-replicate CR-KP isolated from invasive infections during two different study periods (2011-12 and 2013). Carbapenemase genes were searched for by filter hybridization and confirmed by PCR and sequencing. KPC-producing K. pneumoniae (KPC-KP) were typed by PFGE and MLST. Capsular types were identified by wzi gene typing. Results: Of the collected K. pneumoniae isolates (n=461), the overall proportion of CR-KP was 36.2% (n=167). The majority (97%) of the CR-KP were positive for the blaKPC gene. Among the KPC-KP population, nine different STs were detected with the majority of isolates (94%) belonging to the clonal group (CG) 258. A subpopulation that belonged to ST512 and showed an identical PFGE profile represented the majority (57%) of KPC-KP strains, with a countrywide distribution. Capsular characterization showed the predominance of the wzi154, cps-2 capsular type (88.8% of all CG258 strains). ST258 strains were associated with both cps-1 and cps-2 capsular types, while ST512 was associated with cps-2 only. Conclusions: Although a trend to a polyclonal evolution of the Italian KPC-KP was noted, this study showed that the KPC-KP population remained largely oligoclonal with the wide diffusion of an ST512 lineage carrying cps-2 capsular type and producing the KPC-3 enzyme.
UR - http://hdl.handle.net/10447/417929
M3 - Article
VL - 71
SP - 1
EP - 6
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
SN - 0305-7453
ER -