Microbiological features of KPC-producing Enterobacter isolates identified in a U.S. hospital system

Diagn Microbiol Infect Dis. 2014 Oct;80(2):154-8. doi: 10.1016/j.diagmicrobio.2014.06.010. Epub 2014 Jun 23.

Abstract

Microbiological data regarding Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacter spp. are scarce. In this study, 11 unique KPC-producing Enterobacter isolates were identified among 44 ertapenem-nonsusceptible Enterobacter isolates collected between 2009 and 2013 at a hospital system in Western Pennsylvania. All cases were healthcare-associated and occurred in medically complex patients. While pulsed-field gel electrophoresis showed diverse restriction patterns overall, multilocus sequence typing identified Enterobacter cloacae isolates with sequence types 93 and 171 from 2 hospitals each. The levels of carbapenem minimum inhibitory concentrations were highly variable. All isolates remained susceptible to colistin and tigecycline, and the majority, to amikacin and doxycycline. A blaKPC-carrying IncN plasmid conferring trimethoprim-sulfamethoxazole resistance was identified in 3 of the isolates. Spread of blaKPC in Enterobacter spp. appears to be due to a combination of plasmid-mediated and clonal processes.

Keywords: Enterobacter aerogenes; Enterobacter cloacae; Klebsiella pneumoniae carbapenemease.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / metabolism*
  • Cross Infection / epidemiology
  • Cross Infection / microbiology*
  • Electrophoresis, Gel, Pulsed-Field
  • Enterobacter cloacae / classification*
  • Enterobacter cloacae / enzymology*
  • Enterobacter cloacae / genetics
  • Enterobacter cloacae / isolation & purification
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / microbiology*
  • Ertapenem
  • Female
  • Genotype
  • Hospitals
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Molecular Epidemiology
  • Multilocus Sequence Typing
  • Pennsylvania / epidemiology
  • Plasmids / analysis
  • Young Adult
  • beta-Lactam Resistance
  • beta-Lactamases / metabolism*
  • beta-Lactams / pharmacology

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • beta-Lactams
  • beta-Lactamases
  • carbapenemase
  • Ertapenem