Molecular and epidemiological analysis of IMP-1 metallo-β-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Japan

This study investigated the molecular and phenotypic characteristics of carbapenemase-producing Klebsiella pneumoniae, and identified the risk factors underlying its acquisition. We evaluated K. pneumoniae isolated in Nagasaki University Hospital between January 2009 and June 2015. The presence of c...

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Veröffentlicht in:Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2019-04, Vol.25 (4), p.240-246
Hauptverfasser: Yamakawa, Hiromi, Kosai, Kosuke, Akamatsu, Norihiko, Matsuda, Junichi, Kaku, Norihito, Uno, Naoki, Morinaga, Yoshitomo, Hasegawa, Hiroo, Tsubouchi, Taishi, Kaneko, Yukihiro, Miyazaki, Taiga, Izumikawa, Koichi, Mukae, Hiroshi, Yanagihara, Katsunori
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container_issue 4
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container_title Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
container_volume 25
creator Yamakawa, Hiromi
Kosai, Kosuke
Akamatsu, Norihiko
Matsuda, Junichi
Kaku, Norihito
Uno, Naoki
Morinaga, Yoshitomo
Hasegawa, Hiroo
Tsubouchi, Taishi
Kaneko, Yukihiro
Miyazaki, Taiga
Izumikawa, Koichi
Mukae, Hiroshi
Yanagihara, Katsunori
description This study investigated the molecular and phenotypic characteristics of carbapenemase-producing Klebsiella pneumoniae, and identified the risk factors underlying its acquisition. We evaluated K. pneumoniae isolated in Nagasaki University Hospital between January 2009 and June 2015. The presence of carbapenemase genes and plasmid characteristics were investigated. We performed multilocus sequence typing (MLST), and generated a dendrogram based on the results of pulsed-field gel electrophoresis (PFGE) for carbapenemase-producing strains. We also performed a case-control study of patients. Of the 88 K. pneumoniae strains that showed minimum inhibitory concentration ≥1 μg/mL for imipenem and/or meropenem, and that were available from our bacterial collection, 18 had the IMP-type carbapenemase gene, all of which were IMP-1 according to sequencing analysis. Strains included seven different sequence types (STs), of which the most common was ST1471. A dendrogram showed the significant similarity of some strains with relationships in PFGE patterns, STs, and the wards in which they were isolated. Plasmid incompatibility group was similar among the IMP-1 producers. Regarding risk factors, multivariate analysis showed that liver disease and previous uses of carbapenems and anti-fungal drugs were significant factors for the acquisition of IMP-1-producing strains. Our results demonstrate that IMP-1 is a major carbapenemase produced by K. pneumoniae. The PFGE results indicated the possibility of transmission in the hospital. The identified risk factors should be considered for appropriate antibiotic therapy and infection-control measures.
doi_str_mv 10.1016/j.jiac.2018.11.012
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We evaluated K. pneumoniae isolated in Nagasaki University Hospital between January 2009 and June 2015. The presence of carbapenemase genes and plasmid characteristics were investigated. We performed multilocus sequence typing (MLST), and generated a dendrogram based on the results of pulsed-field gel electrophoresis (PFGE) for carbapenemase-producing strains. We also performed a case-control study of patients. Of the 88 K. pneumoniae strains that showed minimum inhibitory concentration ≥1 μg/mL for imipenem and/or meropenem, and that were available from our bacterial collection, 18 had the IMP-type carbapenemase gene, all of which were IMP-1 according to sequencing analysis. Strains included seven different sequence types (STs), of which the most common was ST1471. A dendrogram showed the significant similarity of some strains with relationships in PFGE patterns, STs, and the wards in which they were isolated. Plasmid incompatibility group was similar among the IMP-1 producers. Regarding risk factors, multivariate analysis showed that liver disease and previous uses of carbapenems and anti-fungal drugs were significant factors for the acquisition of IMP-1-producing strains. Our results demonstrate that IMP-1 is a major carbapenemase produced by K. pneumoniae. The PFGE results indicated the possibility of transmission in the hospital. 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Regarding risk factors, multivariate analysis showed that liver disease and previous uses of carbapenems and anti-fungal drugs were significant factors for the acquisition of IMP-1-producing strains. Our results demonstrate that IMP-1 is a major carbapenemase produced by K. pneumoniae. The PFGE results indicated the possibility of transmission in the hospital. 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subjects Carbapenemase
MLST
Risk factors
title Molecular and epidemiological analysis of IMP-1 metallo-β-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Japan
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