Presence of plasmid-mediated quinolone resistance in klebsiella pneumoniae isolates possessing blaKPC in the United States

Endimiani, Andrea, Carias, Lenore L., Hujer, Andrea M., Bethel, Christopher R., Hujer, Kristine M., Perez, Federico, Hutton, Rebecca A., Fox, William R., Hall, Geraldine S., Jacobs, Michael R., Paterson, David L., Rice, Louis B., Jenkins, Stephen G., Tenover, Fred C. and Bonomo, Robert A. (2008) Presence of plasmid-mediated quinolone resistance in klebsiella pneumoniae isolates possessing blaKPC in the United States. Antimicrobial Agents and Chemothery, 52 7: 2680-2682. doi:10.1128/AAC.00158-08

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Author Endimiani, Andrea
Carias, Lenore L.
Hujer, Andrea M.
Bethel, Christopher R.
Hujer, Kristine M.
Perez, Federico
Hutton, Rebecca A.
Fox, William R.
Hall, Geraldine S.
Jacobs, Michael R.
Paterson, David L.
Rice, Louis B.
Jenkins, Stephen G.
Tenover, Fred C.
Bonomo, Robert A.
Title Presence of plasmid-mediated quinolone resistance in klebsiella pneumoniae isolates possessing blaKPC in the United States
Journal name Antimicrobial Agents and Chemothery   Check publisher's open access policy
ISSN 0066-4804
Publication date 2008-07
Year available 2008
Sub-type Article (original research)
DOI 10.1128/AAC.00158-08
Open Access Status File (Publisher version)
Volume 52
Issue 7
Start page 2680
End page 2682
Total pages 3
Editor A.P. Johnson
Place of publication Washington, DC, United States
Publisher American Society for Microbiology
Collection year 2009
Language eng
Subject C1
920109 Infectious Diseases
110309 Infectious Diseases
Formatted abstract
The emergence of bla(KPC)-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 beta-lactams (MIC(90)s >or= 128 mg/L). Among carbapenems, MIC(50/90)s 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: bla(KPC-2) (59.5%), bla(KPC-3) (40.5%), bla(TEM-1) (90.5%), bla(SHV-11) (95.2%) and bla(SHV-12) (50.0%). aIEF of crude beta-lactamase extracts from these strains supported our findings, showing beta-lactamases at pIs of 5.4, 7.6 and 8.2. The mean number of beta-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 bla(KPC-2) and 12 bla(KPC-3)) were detected in each of the five institutions. rep-PCR showed patterns consistent with PFGE.


We demonstrated the complex beta-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 Klebsiella pneumoniae
KPC β-lactamases
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
UQ Centre for Clinical Research Publications
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Citation counts: TR Web of Science Citation Count  Cited 55 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 19 Jan 2010, 14:17:55 EST by Ms May Balasaize on behalf of Faculty Of Health Sciences