Isolation of a Klebsiella pneumoniae isolate of sequence type 258 producing KPC-2 carbapenemase in Korea
Kyoung Ho Roh1, Chang Kyu Lee, Jang Wook Sohn
1Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea.
Abstract:
Carbapenem-resistant Klebsiella pneumoniae isolates producing K. pneumoniae carbapenemases (KPC) were first reported in the USA in 2001, and since then, this infection has been reported in Europe, Israel, South America, and China. In Korea, the first KPC-2-producing K. pneumoniae sequence type (ST) 11 strain was detected in 2010. We report the case of a patient with a urinary tract infection caused by KPC-2-producing K. pneumoniae. This is the second report of a KPC-2-producing K. pneumoniae infection in Korea, but the multilocus sequence type was ST258. The KPC-2-producing isolate was resistant to all tested β-lactams (including imipenem and meropenem), amikacin, tobramycin, ciprofloxacin, levofloxacin, and trimethoprim-sulfamethoxazole, but was susceptible to gentamicin, colistin, polymyxin B, and tigecycline. The KPC-2-producing isolate was negative to phenotypic extended-spectrum β-lactamase (ESBL) and AmpC detection tests and positive to modified Hodge test and carbapenemase inhibition test with aminophenylboronic acid.
Insights
Carbapenem-resistant Klebsiella pneumoniae infections are spreading globally. A new case in Korea involved a multidrug-resistant strain, highlighting the need for continued surveillance and treatment options.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Carbapenem-resistant Klebsiella pneumoniae (CRKP) producing K. pneumoniae carbapenemases (KPC) emerged in 2001.
- CRKP infections have spread globally, with the first KPC-2-producing ST11 strain detected in Korea in 2010.
Observation:
- This report details a urinary tract infection in Korea caused by KPC-2-producing K. pneumoniae.
- The identified strain was ST258, a different sequence type than previously reported in Korea.
Findings:
- The KPC-2-producing isolate exhibited resistance to multiple antibiotics, including all tested beta-lactams, aminoglycosides, fluoroquinolones, and trimethoprim-sulfamethoxazole.
- Susceptibility was observed for gentamicin, colistin, polymyxin B, and tigecycline.
- Phenotypic tests for ESBL and AmpC were negative, but modified Hodge and carbapenemase inhibition tests were positive.
Implications:
- This case represents the second report of KPC-2-producing K. pneumoniae in Korea and the first ST258 isolate.
- The findings underscore the evolving epidemiology of CRKP and the importance of molecular characterization.
- Effective treatment options for this resistant strain include gentamicin, colistin, polymyxin B, and tigecycline.
