Characterization of KPC-2-producing Klebsiella pneumoniae and affected patients of a pediatric hospital in Brazil

Diagn Microbiol Infect Dis. 2023 Jun;106(2):115932. doi: 10.1016/j.diagmicrobio.2023.115932. Epub 2023 Mar 4.

Abstract

Carbapenemase-producing Klebsiella pneumoniae (CPKp) infections are important threats to pediatric populations. Thus, a retrospective study was conducted in a Brazilian reference pediatric hospital, and 26 CPKp isolates obtained from 23 patients were characterized. The affected population had important underlying diseases, reflecting previous hospitalization and antibiotic use. Most CPKp isolates were resistant to all antibiotic classes, and blaKPC-2 was the only carbapenemase-encoding gene. blaCTX-M-15 was common among the isolates, and modification or absence of the mgrB gene was the cause of polymyxin B resistance. Ten different sequence types were identified, and clonal complex 258 was prevalent. Alleles wzi50 and wzi64 were the most recurrent ones regarding K-locus type, with a remarkable contribution of the epidemic ST11/KL64 lineage as a colonizer. Our findings show that lineages associated with the pediatric population are similar to those found in adults, reinforcing the need for epidemiological surveillance to effectively implement prevention and control measures.

Keywords: Beta-lactamase epidemiology; Carbapenemase; Child; Multidrug-resistance.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics
  • Brazil / epidemiology
  • Carbapenem-Resistant Enterobacteriaceae*
  • Child
  • Hospitals, Pediatric
  • Humans
  • Klebsiella Infections* / epidemiology
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / genetics
  • Microbial Sensitivity Tests
  • Multilocus Sequence Typing
  • Retrospective Studies
  • beta-Lactamases* / genetics

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • beta-Lactamases
  • beta-lactamase KPC-2, Klebsiella pneumoniae