Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A β-lactamase, KPC-3, in a New York Medical Center

Neil Woodford, Philip M. Tierno, Katherine Young, Luke Tysall, Marie France I. Palepou, Elaina Ward, Ronald E. Painter, Deborah F. Suber, Daniel Shungu, Lynn L. Silver, Kenneth Inglima, John Kornblum, David M. Livermore

Research output: Contribution to journalArticlepeer-review

382 Citations (Scopus)

Abstract

From April 2000 to April 2001, 24 patients in intensive care units at Tisch Hospital, New York, N.Y., were infected or colonized by carbapenem-resistant Klebsiella pneumoniae. Pulsed-field gel electrophoresis identified a predominant outbreak strain, but other resistant strains were also recovered. Three representatives of the outbreak strain from separate patients were studied in detail. All were resistant or had reduced susceptibility to imipenem, meropenem, ceftazidime, piperacillin-tazobactam, and gentamicin but remained fully susceptible to tetracycline. PCR amplified a blaKPC encoding a novel variant, KPC-3, with a His(272)→Tyr substitution not found in KPC-2; other carbapenemase genes were absent. In the outbreak strain, KPC-3 was encoded by a 75-kb plasmid, which was transferred in vitro by electroporation and conjugation. The isolates lacked the OmpK35 porin but expressed OmpK36, implying reduced permeability as a cofactor in resistance. This is the third KPC carbapenem-iiydrolyzing β-lactamase variant to have been reported in members of the Enterobacteriaceae, with others reported from the East Coast of the United States. Although producers of these enzymes remain rare, the progress of this enzyme group merits monitoring.

Original languageEnglish
Pages (from-to)4793-4799
Number of pages7
JournalAntimicrobial Agents and Chemotherapy
Volume48
Issue number12
DOIs
Publication statusPublished - Dec 2004

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