Characterization of Carbapenem-Resistant Klebsiella pneumoniae ST15 Clone Coproducing KPC-2, CTX-M-15 and SHV-28 Spread in an Intensive Care Unit of a Tertiary Hospital

Figures & data

Table 1 Resistance and Susceptibility of ST15 CRKP Isolates to Antimicrobial Agents

Antibiotics	%R	%S	MIC50	MIC90	MIC Range(mg/L)
Amikacin	0	100	≤2	16	≤2–16
Tigecycline	0	91.3	1	2	0.25–4
Polymyxin B	0	100	1	1	0.5–1
Imipenem	100	0	>16	>16	8–>16
Meropenem	100	0	>16	>16	>16–>16
Cotrimoxazole	43.5	56.5	≤1	8	≤1–>16
Tobramycin	95.7	0	>16	>16	8–>16
Gentamicin	100	0	>16	>16	>16–>16
Levofloxacin	100	0	>8	>8	>8–>8
Ciprofloxacin	100	0	>4	>4	>4–>4
Aztreonam	100	0	>64	>64	>64–>64
Cefotetan	100	0	>64	>64	>64–>64
Cefepime	100	0	>64	>64	32–>64
Ceftazidime	100	0	>64	>64	16–>64
Cefazolin	100	0	>64	>64	>64–>64
Cefuroxime	100	0	>64	>64	>64–>64
Ceftriaxone	100	0	>64	>64	32–>64
Piperacillin	100	0	>128	>128	>128–>128
Piperacillin/tazobactam	100	0	>128	>128	>128–>128
Ampicillin/sulbactam	100	0	>32	>32	>32–>32

Abbreviations: R, resistant; S, susceptible.

Table 2 Distribution of Resistance Genes in CRKP Isolates

Resistance Genes	MIC Range (mg/L)					PFGE	MLST (Number)
	AMK	IPM	MEM	TGC	POL
KPC-2+qnrS1+rmtB1	>64	>16	>16	0.5	1	D	ST11 (2)
KPC-2+CTX-M-65+TEM-1+aac(6ʹ)-Ib-cr+rmtB1	>64	>16	>16	0.25	0.5–1	C	ST11 (2)
KPC-2+CTX-M-65+CTX-M-3+TEM-1+qnrB+qnrS1+aac(6ʹ)-Ib-cr+armA	>64	>16	>16	4	1	E	ST11 (1)
KPC-2+SHV-28+qnrS1	≤2	>16	>16	0.25	0.5	B	ST15 (1)
KPC-2+SHV-28+OXA-1+qnrS1+aac(6ʹ)-Ib-cr	≤2	>16	>16	4	1	A	ST15 (1)
KPC-2+CTX-M-15+SHV-28+TEM-1+OXA-1+aac(6ʹ)-Ib-cr	≤2–16	8->16	>16	0.25–4	0.5–1	A	ST15 (21)

Abbreviations: AMK, amikacin; IPM, imipenem; MEM, meropenem; TGC, tigecycline; POL, polymyxin B.

Figure 1 DNA fingerprints, resistance genes distribution and isolation date of 28 CRKP isolates.