Epidemiology and genetic features of CTX-M-15-producing Klebsiella pneumoniae epidemic clones in Hungary in 2005

Abstract number: 1732_279

Damjanova I., Tóth Á., Hajbel-Vékony G., Pászti J., Berta J., Füzi M.

Objectives: To investigate the dissemination and molecular epidemiology of CTX-M-15-producing K. pneumoniae epidemic clones (KP-EC) identified earlier in Hungary by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).

Methods: 396 ESBL-producing KP clinical isolates were submitted to the National ESBL Reference Laboratory for confirmation in 2005. On the basis of phage types 190 isolates from 38 healthcare facilities were selected for testing by PFGE and representative isolates were further characterised by MLST.

Antimicrobial susceptibility testing was performed by disk diffusion according to the CLSI. The carriage of blaCTX-M and ISEcp1 were investigated by PCR and CTX-M amplicons sequenced. The transferability of ESBL genes in representative isolates was tested and the plasmid profiles analysed.

Results: Three CTX-M-15-producing KP-ECs were identified all showing high level resistance to ciprofloxacin. The previously described K. pneumoniae Hungarian epidemic clone (HEC) spread to 31 healthcare facilities, affecting 124 patients, and causing 3 nosocomial outbreaks. This clone proved identical to sequence type (ST) 15, carried two gyrA mutations, a single parC mutation and blaSHV-28. The second epidemic clone spread to 4 healthcare facilities, affecting 45 patients and causing 2 nosocomial outbreaks. This clone represents a novel sequence type (data submitted to MLST centre), carrying a single gyrA and a single parC mutation. The third epidemic clone spread to 3 healthcare facilities, affecting 21 patients and causing one nosocomial outbreak. This clone corresponds to ST 11, carrying two gyrA and a single parC mutations. ISEcp1 was detected exclusively in strains belonging to the ST 11 clone.

Conclusion: In 2005 the number of infections caused by CTX-M-producing KP rose sharply in Hungary. In addition, a shift was demonstrated in the occurrence of CTX-M-producing KP clones. Three multidrug resistant KP-ECs were detected in 38 healthcare facilities causing large outbreaks and individual nosocomial infections.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Location: ICC, Munich, Germany
Presentation type:
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