Emergence of KPC-2 and KPC-3 in carbapenem-resistant Klebsiella pneumoniae strains in an Israeli hospital

Abstract

Carbapenem resistance due to KPC has rarely been observed outside the United States. We noticed a sharp increase in carbapenem-resistant Klebsiella pneumoniae strains possessing KPC in Tel Aviv Medical Center from 2004 to 2006. Sixty percent of the isolates belonged to a single clone susceptible only to gentamicin and colistin and carried the bla(KPC-3) gene, while almost all other clones carried the bla(KPC-2) gene. This rapid dissemination of KPC outside the United States is worrisome.

Figures

FIG. 1.

Molecular epidemiology and emergence of KPC in carbapenem-resistant K. pneumoniae strains in the Tel Aviv Medical Center from 2004 to 2006. In 2004, four panresistance carbapenem-resistant clones susceptible only to amikacin and colistin were identified. In 2005, KPC emerged in carbapenem-resistant K. pneumoniae isolates. In 2006, nine clones existed; two appeared previously in 2004 and 2005 and lacked KPC, and seven, including clone Q, the major clone that emerged in February 2006, possessed KPC. Four of the seven clones (including clone Q) were susceptible only to gentamicin and colistin, and three clones were susceptible only to amikacin and colistin.