A carbapenem-resistant Klebsiella pneumoniae epidemic clone in Jerusalem: sequence type 512 carrying a plasmid encoding aac(6')-Ib

J Antimicrob Chemother. 2012 Apr;67(4):898-901. doi: 10.1093/jac/dkr552. Epub 2012 Jan 26.


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 bla(KPC-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 bla(KPC) gene, but is similar to pS15, a plasmid from New York that carries bla(KPC-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 bla(KPC-3).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetyltransferases / genetics*
  • Anti-Bacterial Agents / pharmacology*
  • Carbapenems / pharmacology*
  • Cluster Analysis
  • DNA, Bacterial / chemistry
  • DNA, Bacterial / genetics
  • Electrophoresis, Gel, Pulsed-Field
  • Genotype
  • Hospitals
  • Humans
  • Israel / epidemiology
  • Klebsiella Infections / epidemiology*
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification
  • Microbial Sensitivity Tests
  • Molecular Sequence Data
  • Multilocus Sequence Typing
  • Plasmids*
  • Polymerase Chain Reaction
  • Restriction Mapping
  • Sequence Analysis, DNA
  • beta-Lactam Resistance*


  • Anti-Bacterial Agents
  • Carbapenems
  • DNA, Bacterial
  • Acetyltransferases
  • aminoglycoside N(6')-acetyltransferase

Associated data

  • GENBANK/JF828150