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Polyclonal outbreak of KPC-3-producing Enterobacter cloacae at a single hospital in Montreal, Quebec, Canada

Louis-Patrick Haraoui1, Simon Lévesque, Brigitte Lefebvre

  • 1Jewish General Hospital, Montréal, Québec, Canada. louispatrick.haraoui@rrsss16.gouv.qc.ca

Journal of Clinical Microbiology
|May 3, 2013
PubMed

Insights

Carbapenemase-producing Enterobacter cloacae (CPE) infections can be complex. This study found the blaKPC gene on multiple plasmids within diverse E. cloacae strains, indicating a complicated KPC outbreak scenario.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Enterobacter cloacae is an opportunistic pathogen.
  • Carbapenemase-producing Enterobacter cloacae (CPE) poses a significant threat in healthcare settings.
  • The blaKPC gene confers resistance to carbapenem antibiotics.

Purpose of the Study:

  • To investigate the genetic basis and epidemiology of KPC-3-producing Enterobacter cloacae isolates identified at a single hospital.
  • To understand the complexity of a potential KPC outbreak.

Main Methods:

  • Isolates were collected from September 2010 to December 2011.
  • Molecular analyses were performed to identify the presence and location of the blaKPC gene.
  • Plasmid analysis and genetic background characterization of E. cloacae isolates were conducted.

Main Results:

  • Twenty-six KPC-3-producing E. cloacae isolates were identified from 16 patients.
  • The blaKPC gene was found to be located on multiple plasmids.
  • The E. cloacae isolates exhibited a diverse, nonclonal genetic background.

Conclusions:

  • The presence of the blaKPC gene on multiple plasmids within a diverse genetic background complicates the understanding of KPC outbreaks.
  • This highlights the potential for complex transmission dynamics of CPE within a single healthcare facility.
  • Further investigation into the epidemiology and control of such complex outbreaks is warranted.

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