Characterization of blaKPC-containing Klebsiella pneumoniae isolates detected in different institutions in the Eastern USA

Endimiani, Andrea, Hujer, Andrea M., Perez, Federico, Bethel, Christopher R., Hujer, Kristine M., Kroeger, Jennifer, Oethinger, Margret, Paterson, David L., Adams, Mark D., Jacobs, Michael R., Diekema, Daniel J., Hall, Gerri S., Jenkins, Stephen G., Rice, Louis B., Tenover, Fred C. and Bonomo, Robert A. (2009) Characterization of blaKPC-containing Klebsiella pneumoniae isolates detected in different institutions in the Eastern USA. Journal of Antimicrobial Chemotherapy, 63 3: 427-437. doi:10.1093/jac/dkn547

Author Endimiani, Andrea
Hujer, Andrea M.
Perez, Federico
Bethel, Christopher R.
Hujer, Kristine M.
Kroeger, Jennifer
Oethinger, Margret
Paterson, David L.
Adams, Mark D.
Jacobs, Michael R.
Diekema, Daniel J.
Hall, Gerri S.
Jenkins, Stephen G.
Rice, Louis B.
Tenover, Fred C.
Bonomo, Robert A.
Title Characterization of blaKPC-containing Klebsiella pneumoniae isolates detected in different institutions in the Eastern USA
Journal name Journal of Antimicrobial Chemotherapy   Check publisher's open access policy
ISSN 0305-7453
Publication date 2009-01
Year available 2009
Sub-type Article (original research)
DOI 10.1093/jac/dkn547
Volume 63
Issue 3
Start page 427
End page 437
Total pages 11
Editor Alan P. Johnson
Place of publication Oxford, England, U.K.
Publisher Oxford University Press
Collection year 2010
Language eng
Subject 110309 Infectious Diseases
920109 Infectious Diseases
Formatted abstract
The emergence of blaKPC-containing Klebsiella pneumoniae (KPC-Kp) isolates is attracting significant attention. Outbreaks in the Eastern USA have created serious treatment and infection control problems. A comparative multi-institutional analysis of these strains has not yet been performed.

We analysed 42 KPC-Kp recovered during 2006–07 from five institutions located in the Eastern USA. Antimicrobial susceptibility tests, analytical isoelectric focusing (aIEF), PCR and sequencing of bla genes, PFGE and rep-PCR were performed.

By in vitro testing, KPC-Kp isolates were highly resistant to all non-carbapenem β-lactams (MIC90s 128 mg/L). Among carbapenems, MIC50/90s were 4/64 mg/L for imipenem and meropenem, 4/32 mg/L for doripenem and 8/128 for ertapenem. Combinations of clavulanate or tazobactam with a carbapenem or cefepime did not significantly lower the MIC values. Genetic analysis revealed that the isolates possessed the following bla genes: blaKPC-2 (59.5%), blaKPC-3 (40.5%), blaTEM-1 (90.5%), blaSHV-11 (95.2%) and blaSHV-12 (50.0%). aIEF of crude β-lactamase extracts from these strains supported our findings, showing β-lactamases at pIs of 5.4, 7.6 and 8.2. The mean number of β-lactamases was 3.5 (range 3–5). PFGE demonstrated that 32 (76.2%) isolates were clonally related (type A). Type A KPC-Kp isolates (20 blaKPC-2 and 12 blaKPC-3) were detected in each of the five institutions. rep-PCR showed patterns consistent with PFGE.


We demonstrated the complex β-lactamase background of KPC-Kp isolates that are emerging in multiple centres in the Eastern USA. The prevalence of a single dominant clone suggests that interstate transmission has occurred
Keyword carbapenemases
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
2010 Higher Education Research Data Collection
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Citation counts: TR Web of Science Citation Count  Cited 116 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 09 Sep 2009, 15:09:29 EST by Carmen Buttery on behalf of UQ Centre for Clinical Research