Extremely drug-resistant NDM-9-producing ST147 Klebsiella pneumoniae causing infections in Italy, May 2020

Euro Surveill. 2020 Dec;25(48):2001779. doi: 10.2807/1560-7917.ES.2020.25.48.2001779.

Abstract

A large outbreak of New Delhi metallo-beta-lactamase (NDM)-1-producing Klebsiella pneumoniae sequence type (ST) 147 occurred in Tuscany, Italy in 2018-2019. In 2020, ST147 NDM-9-producing K. pneumoniae were detected at the University Hospital of Pisa, Tuscany, in two critically ill patients; one developed bacteraemia. Genomic and phylogenetic analyses suggest relatedness of 2018-2019 and 2020 strains, with a change from NDM-1 to NDM-9 in the latter and evolution by colistin, tigecycline and fosfomycin resistance acquisition.

Keywords: Colistin resistance; Fosfomycin resistance; NDM; Outbreak; Tigecycline resistance; Tuscany; carbapenem resistance.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacteremia / diagnosis
  • Bacteremia / drug therapy*
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Humans
  • Italy
  • Klebsiella Infections / diagnosis
  • Klebsiella Infections / drug therapy*
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / genetics*
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Microbial Sensitivity Tests
  • Multilocus Sequence Typing
  • Phylogeny
  • Plasmids / genetics
  • beta-Lactamases / genetics

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases
  • beta-lactamase NDM-1