Bloodstream Infections caused by Klebsiella pneumoniae and Serratia marcescens isolates co-harboring NDM-1 and KPC-2

Annals of Clinical Microbiology and Antimicrobials

Hermes Higashino¹  Thais Guimaraes²  Taniela Bes³  Silvia Costa⁴  Anna S. Levin⁴  Lauro Perdigão-Neto⁴  Gladys Prado⁵  Roberta Martins⁵  Debora Nagano⁵  Ana Paula Marchi⁵ 

[1] Infectious Diseases Division, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil;Infectious Diseases Division, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil;Infection Control, Hospital das Clínicas Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil;Infectious Diseases Division, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil;Institute of Tropical Medicine of the University of São Paulo, Avenida Dr. Enéas Carvalho de Aguiar, 470; LIM 49, CEP 05403-000, São Paulo, Brazil;Infectious Diseases Division, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil;Institute of Tropical Medicine of the University of São Paulo, Avenida Dr. Enéas Carvalho de Aguiar, 470; LIM 49, CEP 05403-000, São Paulo, Brazil;Infection Control, Hospital das Clínicas Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil;Institute of Tropical Medicine of the University of São Paulo, Avenida Dr. Enéas Carvalho de Aguiar, 470; LIM 49, CEP 05403-000, São Paulo, Brazil;

关键词: Enterobacteriaceae;    Carbapenem resistance;    Carbapenemases;    bla;    bla;   

DOI  :  10.1186/s12941-021-00464-5

来源: Springer

【 摘 要 】

Carbapenem-resistant Enterobacteriaceae are a worldwide health problem and isolates carrying both blaKPC-2 and blaNDM-1 are unusual. Here we describe the microbiological and clinical characteristics of five cases of bloodstream infections (BSI) caused by carbapenem-resistant Klebsiella pneumoniae and Serratia marcescens having both blaKPC-2 and blaNDM-1. Of the five blood samples, three are from hematopoietic stem cell transplantation patients, one from a renal transplant patient, and one from a surgical patient. All patients lived in low-income neighbourhoods and had no travel history. Despite antibiotic treatment, four out of five patients died. The phenotypic susceptibility assays showed that meropenem with the addition of either EDTA, phenylboronic acid (PBA), or both, increased the zone of inhibition in comparison to meropenem alone. Molecular tests showed the presence of blaKPC-2 and blaNDM-1 genes. K. pneumoniae isolates were assigned to ST258 or ST340 by whole genome sequencing. This case-series showed a high mortality among patients with BSI caused by Enterobacteriae harbouring both carbapenemases. The detection of carbapenemase-producing isolates carrying both blaKPC-2 and blaNDM-1 remains a challenge when using only phenotypic assays. Microbiology laboratories must be alert for K. pneumoniae isolates producing both KPC-2 and NDM-1.

【 授权许可】

CC BY