Coproduction of KPC-18 and VIM-1 Carbapenemases by Enterobacter cloacae: Implications for Newer β-Lactam-β-Lactamase Inhibitor Combinations

J Clin Microbiol. 2016 Mar;54(3):791-4. doi: 10.1128/JCM.02739-15. Epub 2015 Dec 30.

Abstract

Enterobacter cloacae strain G6809 with reduced susceptibility to carbapenems was identified from a patient in a long-term acute care hospital in Kentucky. G6809 belonged to sequence type (ST) 88 and carried two carbapenemase genes, bla(KPC-18) and bla(VIM-1). Whole-genome sequencing localized bla(KPC-18) to the chromosome and bla(VIM-1) to a 58-kb plasmid. The strain was highly resistant to ceftazidime-avibactam. Insidious coproduction of metallo-β-lactamase with KPC-type carbapenemase has implications for the use of next-generation β-lactam-β-lactamase inhibitor combinations.

Publication types

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

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / biosynthesis*
  • Drug Resistance, Bacterial
  • Enterobacter cloacae / drug effects
  • Enterobacter cloacae / enzymology*
  • Enterobacter cloacae / genetics
  • Enterobacteriaceae Infections / microbiology*
  • Gene Order
  • Genetic Loci
  • Humans
  • Microbial Sensitivity Tests
  • beta-Lactamase Inhibitors / pharmacology
  • beta-Lactamases / biosynthesis*
  • beta-Lactams / pharmacology

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • beta-Lactamase Inhibitors
  • beta-Lactams
  • beta-Lactamases
  • carbapenemase