TY - JOUR
T1 - Reversion to susceptibility of a carbapenem-resistant clinical isolate of klebsiella pneumoniae producing KPC-3
AU - Villa, Laura
AU - Capone, Alessandro
AU - Fortini, Daniela
AU - Dolejska, Monika
AU - Rodri'guez, Irene
AU - Taglietti, Fabrizio
AU - De Paolis, Paolo
AU - Petrosillo, Nicola
AU - Carattoli, Alessandra
PY - 2013/11
Y1 - 2013/11
N2 - Objectives:We report the case of a kidney-transplant patient, suffering an intra-abdominal abscess at the surgical site caused by a carbapenem-resistant ST258 Klebsiella pneumoniae clone, producing the KPC-3 carbapenemase. Under tigecycline treatment, the patient developed a sepsis caused by a carbapenem-susceptible ST258 K. pneumoniae strain. Complete DNA sequences of the plasmids carried by the resistant and susceptible strains from this patient were determined. Methods: The complete DNA sequences of plasmids were obtained by applying the 454 Genome Sequencer FLXPLUSprocedure onalibrary constructed of total plasmidDNApurified fromthe carbapenem-resistantand-susceptible strains. Results: In the carbapenem-resistant strain, four plasmids encoding 24 resistance genes, including blaKPC-3, and two putative virulence clusters were detected. In the susceptible strain, large rearrangements occurred in the KPC-carrying plasmid, causing the deletion of the entire Tn4401::blaKPC-3 transposon, with the consequent reversion of the strain to carbapenem susceptibility. The patient was successfully treated with carbapenems and fully recovered. Conclusions: The description of the plasmid content in these two strains gives interesting insights into the plasticity of KPC-carrying plasmids in K. pneumoniae.
AB - Objectives:We report the case of a kidney-transplant patient, suffering an intra-abdominal abscess at the surgical site caused by a carbapenem-resistant ST258 Klebsiella pneumoniae clone, producing the KPC-3 carbapenemase. Under tigecycline treatment, the patient developed a sepsis caused by a carbapenem-susceptible ST258 K. pneumoniae strain. Complete DNA sequences of the plasmids carried by the resistant and susceptible strains from this patient were determined. Methods: The complete DNA sequences of plasmids were obtained by applying the 454 Genome Sequencer FLXPLUSprocedure onalibrary constructed of total plasmidDNApurified fromthe carbapenem-resistantand-susceptible strains. Results: In the carbapenem-resistant strain, four plasmids encoding 24 resistance genes, including blaKPC-3, and two putative virulence clusters were detected. In the susceptible strain, large rearrangements occurred in the KPC-carrying plasmid, causing the deletion of the entire Tn4401::blaKPC-3 transposon, with the consequent reversion of the strain to carbapenem susceptibility. The patient was successfully treated with carbapenems and fully recovered. Conclusions: The description of the plasmid content in these two strains gives interesting insights into the plasticity of KPC-carrying plasmids in K. pneumoniae.
KW - Plasmids
KW - Sequence type 258
KW - Transplant
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U2 - 10.1093/jac/dkt235
DO - 10.1093/jac/dkt235
M3 - Article
C2 - 23800906
AN - SCOPUS:84886248065
VL - 68
SP - 2482
EP - 2486
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
SN - 0305-7453
IS - 11
M1 - dkt235
ER -