Molecular characterization of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae in Ontario, Canada, 2008-2011

PLoS One. 2014 Dec 30;9(12):e116421. doi: 10.1371/journal.pone.0116421. eCollection 2014.

Abstract

Due to the lack of detailed reports of Klebsiella pneumoniae carbapenemase (KPC)-producing enterobacteria in Ontario, Canada, we perform a molecular characterization of KPC-producing Enterobacteriaceae submitted to the provincial reference laboratory from 2008 to 2011. Susceptibility profiles were accessed by E-test. Molecular types of isolates were determined by pulse-field gel electrophoresis (PFGE) and multilocus sequence typing. Screening of ß-lactamase genes was performed by multiplex PCR and alleles were identified by DNA sequencing. The genetic platform of blaKPC gene was analyzed by PCR. Plasmid replicons were typed using PCR-based typing approach. KPC-plasmids were also evaluated by S1 nuclease-PFGE and Southern blot. Thirty unique clinical isolates (26 Klebsiella pneumoniae, 2 Enterobacter cloacae, 1 Citrobacter freundii and 1 Raoultella ornithinolytica) were identified as blaKPC positive: 4 in 2008, 3 in 2009, 10 in 2010 and 13 in 2011. The majority exhibited resistance to carbapenems, cephalosporins and fluoroquinolones and two isolates were also resistant to colistin. The isolates harbored blaKPC-2 (n = 23) or blaKPC-3 (n = 7). blaTEM-1 (n = 27) was commonly detected and occasionally blaOXA-1 (n = 3) and blaCTX-M-15 (n = 1). As expected, all K. pneumoniae isolates carried blaSHV-11. blaKPC genes were identified on Tn4401a (n = 20) or b (n = 10) isoforms, on plasmids of different sizes belonging to the incompatibility groups IncFIIA (n = 19), IncN (n = 3), IncI2 (n = 3), IncFrep (n = 2) and IncA/C (n = 1). The occurrence of KPC ß-lactamase in Ontario was mainly associated with the spread of the K. pneumoniae clone ST258.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bacterial Proteins / metabolism*
  • DNA, Bacterial / genetics*
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Humans
  • Klebsiella Infections / microbiology*
  • Klebsiella Infections / urine
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / genetics*
  • Klebsiella pneumoniae / isolation & purification*
  • Male
  • Microbial Sensitivity Tests
  • Multilocus Sequence Typing
  • Ontario
  • Plasmids / genetics
  • beta-Lactamases / metabolism*

Substances

  • Bacterial Proteins
  • DNA, Bacterial
  • beta-Lactamases
  • carbapenemase

Grants and funding

This work was supported by Public Health Ontario internal funding. The authors received no specific funding for this work. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.