Spread of Klebsiella pneumoniae ST395 non-susceptible to carbapenems and resistant to fluoroquinolones in North-Eastern France - Archive ouverte HAL
Article Dans Une Revue Journal of Global Antimicrobial Resistance Année : 2017

Spread of Klebsiella pneumoniae ST395 non-susceptible to carbapenems and resistant to fluoroquinolones in North-Eastern France

Résumé

Fluoroquinolones (FQ) are potential treatments to treat infections from extended-spectrum β-lactamase producing-Enterobacteriaceae susceptible to FQ. Due to increasing non-susceptibility to carbapenems among Enterobacteriaceae, we characterized FQ resistance mechanisms in 36 Klebsiella pneumoniae isolates that are non-susceptible to ertapenem in North-Eastern France in 2012 and described the population structure by pulsed field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST). Among them, 36% (13/36) carried a carbapenemase encoding-gene. Decreased expression of the OmpK35 encoding-gene might be considered a major resistance determinant that could explain non-susceptibility to carbapenems. The carbapenemase-producing isolates carried the well-known IncL pOXA48a plasmid. All the K. pneumoniae (36/36) isolates also harbored a fluoroquinolone-resistant (FQ-R) determinant. aac(6')-Ib-cr was the major plasmid-mediated quinolone resistant (PMQR) determinant found in K. pneumoniae (86%, 32/36). The MLST study identified 5 sequence types (STs). The most dominant ST was ST395 (25/36) followed by ST147 (6/36). ST395 strains showed ertapenem minimum inhibitory concentrations (MICs) ranging from 0.75μg/mL to 32μg/mL.K. pneumoniae ST395 did not show enhanced biofilm formation, nor environmental survival, but showed higher chlorhexidine MICs than the ST147 isolates. These findings showed that (i) K. pneumoniae ST395 carrying pOXA-48a has spread in North-Eastern France, (ii) aac(6')-Ib-cr is preponderant in carbapenem non-susceptible K. pneumoniae, (iii) K. pneumoniae ST395 is resistant to chlorhexidine, and (iv) FQ as alternatives to β-lactams to treat ertapenem non-susceptible K. pneumoniae are compromised.
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Dates et versions

hal-01712200 , version 1 (19-02-2018)

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Anaëlle Muggeo, Thomas Guillard, Frédéric Klein, Fany F. Reffuveille, Caroline François, et al.. Spread of Klebsiella pneumoniae ST395 non-susceptible to carbapenems and resistant to fluoroquinolones in North-Eastern France. Journal of Global Antimicrobial Resistance, 2017, ⟨10.1016/j.jgar.2017.10.023⟩. ⟨hal-01712200⟩
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