IMP-producing carbapenem-resistant Klebsiella pneumoniae in the United States

J Clin Microbiol. 2011 Dec;49(12):4239-45. doi: 10.1128/JCM.05297-11. Epub 2011 Oct 12.

Abstract

The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) producing acquired carbapenemases have created a global public health crisis. In the United States, CRE producing the Klebsiella pneumoniae carbapenemase (KPC) are increasingly common and are endemic in some regions. Metallo-β-lactamase (MBL)-producing CRE have recently been reported in the United States among patients who received medical care in countries where such organisms are common. Here, we describe three carbapenem-resistant K. pneumoniae isolates recovered from pediatric patients at a single U.S. health care facility, none of whom had a history of international travel. The isolates were resistant to carbapenems but susceptible to aztreonam, trimethoprim-sulfamethoxazole, and fluoroquinolones. The three isolates were closely related to each other by pulsed-field gel electrophoresis and contained a common plasmid. PCR and sequence analysis confirmed that these isolates produce IMP-4, an MBL carbapenemase not previously published as present among Enterobacteriaceae in the United States.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / genetics
  • Bacterial Proteins / metabolism*
  • Carbapenems / pharmacology*
  • Cluster Analysis
  • DNA Fingerprinting
  • DNA, Bacterial / genetics
  • Electrophoresis, Gel, Pulsed-Field
  • Female
  • Genotype
  • Humans
  • Infant
  • Infant, Newborn
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / classification
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / enzymology*
  • Klebsiella pneumoniae / isolation & purification*
  • Male
  • Molecular Typing
  • Plasmids / analysis
  • Polymerase Chain Reaction
  • Sequence Analysis, DNA
  • United States
  • beta-Lactam Resistance*
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • DNA, Bacterial
  • beta-Lactamases
  • carbapenemase