Risk Factors and Outcomes for Carbapenem-Resistant Klebsiella pneumoniae Isolation, Stratified by Its Multilocus Sequence Typing: ST258 Versus Non-ST258

Sorabh Dhar; Emily T Martin; Paul R Lephart; John P McRoberts; Teena Chopra; Timothy T Burger; Ruthy Tal-Jasper; Kayoko Hayakawa; Hadas Ofer-Friedman; Tsilia Lazarovitch; Ronit Zaidenstein; Federico Perez; Robert A Bonomo; Keith S Kaye; Dror Marchaim

doi:10.1093/ofid/ofv213

Risk Factors and Outcomes for Carbapenem-Resistant Klebsiella pneumoniae Isolation, Stratified by Its Multilocus Sequence Typing: ST258 Versus Non-ST258

Open Forum Infect Dis. 2016 Feb 12;3(1):ofv213. doi: 10.1093/ofid/ofv213. eCollection 2016 Jan.

Authors

Affiliations

¹ Department of Medicine, Division of Infectious Diseases , Wayne State University , Detroit, Michigan.
² Department of Epidemiology , University of Michigan School of Public Health , Detroit.
³ Department of Clinical Microbiology , Detroit Medical Center, Wayne State University , Michigan.
⁴ Sackler School of Medicine , Tel-Aviv University.
⁵ Division of Infectious Diseases , Assaf Harofeh Medical Center.
⁶ Department of Clinical Microbiology , Assaf Harofeh Medical Center , Zerifin , Israel.
⁷ Research Service, Case Western Reserve University, Cleveland; VISN 10 Geriatric Research, Education, and Clinical Center (GRECC) at Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Case Western Reserve University.
⁸ Research Service, Case Western Reserve University, Cleveland; VISN 10 Geriatric Research, Education, and Clinical Center (GRECC) at Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Case Western Reserve University; Departments ofMedicine; Pharmacology; Molecular Biology and Microbiology, Case Western Reserve University, Cleveland, Ohio.
⁹ Sackler School of Medicine, Tel-Aviv University; Division of Infectious Diseases, Assaf Harofeh Medical Center.

Abstract

A "high risk" clone of carbapenem-resistant Klebsiella pneumoniae (CRKP) identified by multilocus sequence typing (MLST) as sequence type (ST) 258 has disseminated worldwide. As the molecular epidemiology of the CRE pandemic continues to evolve, the clinical impact of non-ST258 strains is less well defined. We conducted an epidemiological investigation of CRKP based on strains MLST. Among 68 CRKP patients, 61 were ST258 and 7 belonged to non-ST258. Klebsiella pneumoniae ST258 strains were significantly associated with bla KPC production and with resistance to an increased number of antimicrobials. Clinical outcomes were not different. Based on this analysis, one cannot rely solely on the presence of bla KPC in order to diagnose CRKP.

Keywords: CRE; KPC; MDRO; outcome; risk factors.

Abstract

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