TY - JOUR
T1 - Persistence of Klebsiella pneumoniae ST258 as the predominant clone of carbapenemase-producing Enterobacteriaceae in post-acute-care hospitals in Israel, 2008-13
AU - Post-Acute-Care Hospital Carbapenem-Resistant Enterobacteriaceae Working Group
AU - Adler, Amos
AU - Hussein, Omar
AU - Ben-david, Debby
AU - Masarwa, Samira
AU - Navon-venezia, Shiri
AU - Schwaber, Mitchell J.
AU - Carmeli, Yehuda
AU - Setton, Eric
AU - Golan, Shulamit
AU - Brill, Shai
AU - Lipkin, Valentina
AU - Frodin, Evgeny
AU - Mendelson, G.
AU - Rave, Rachel
AU - Yehuda, Nava
AU - Aizen, Ira
AU - Kaganski, Michael
AU - Gershkovich, Polina
AU - Sasson, Ady
AU - Yosef, Hana
AU - Stessman, Jochanan
AU - Zlatkin, Sofia
AU - Or, Ilana
AU - Lazary, Avraham
AU - Weinberg, Irina
AU - Madjar, Jack
AU - Taichman, Shoshi
AU - Ben-israel, Joshua
AU - Vigder, Carola
AU - Bar'el, Chaim
AU - Davidovitch, Yosef
AU - Charish, Larisa
N1 - Publisher Copyright:
© The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Objectives: To study the molecular characteristics of carbapenemase-producing Enterobacteriaceae (CPE) in post-acute-care hospitals (PACHs) in Israel and to analyse the temporal changes between 2008 and 2013. Methods: CPE isolates were obtained during two cross-sectional, point prevalence national surveys of PACHs in Israel performed in 2008 and 2013. Surveillance cultures were collected by streaking rectal swabs onto selective media. Isolates were identified to species level and tested for blaKPC, blaNDM and blaOXA-48 by PCR and by the Carba NP test. Molecular typing was done by PCR for the pilv-l gene, designed for the ST258 KPC-producing Klebsiella pneumoniae (KPC-KP) clone, BOX-PCR and MLST. Results: The prevalence of CPE carriage in the first survey was 184/1147 (16%); all of the isolates were KPC-KP. The prevalence of CPE carriage in the second survey was 127/1287 (9.9%); of these isolates, 113 (89%) were KPC-KP, 9 (7%) were other KPC-producing species and 5 (4%) were NDM- and OXA-48-producing CPE (n = 1 and 4, respectively). The proportion of the KPC-KP population represented by the ST258 clone increased from 120/184 (65%) in 2008 to 91/113 (80%) in 2013. In 58% (71/122) of the KPC-CPE carriers identified in the 2013 survey, the source of acquisition was determined to be the PACH itself. All four OXA-48 CPE were acquired either directly or indirectly from patients arriving from the Palestinian Authority or Syria. Conclusions: Despite the decreased prevalence of CPE in Israeli PACHs, and the emergence of new types of CPE, the KPC-KP ST258 clone remains the predominant clone represented.
AB - Objectives: To study the molecular characteristics of carbapenemase-producing Enterobacteriaceae (CPE) in post-acute-care hospitals (PACHs) in Israel and to analyse the temporal changes between 2008 and 2013. Methods: CPE isolates were obtained during two cross-sectional, point prevalence national surveys of PACHs in Israel performed in 2008 and 2013. Surveillance cultures were collected by streaking rectal swabs onto selective media. Isolates were identified to species level and tested for blaKPC, blaNDM and blaOXA-48 by PCR and by the Carba NP test. Molecular typing was done by PCR for the pilv-l gene, designed for the ST258 KPC-producing Klebsiella pneumoniae (KPC-KP) clone, BOX-PCR and MLST. Results: The prevalence of CPE carriage in the first survey was 184/1147 (16%); all of the isolates were KPC-KP. The prevalence of CPE carriage in the second survey was 127/1287 (9.9%); of these isolates, 113 (89%) were KPC-KP, 9 (7%) were other KPC-producing species and 5 (4%) were NDM- and OXA-48-producing CPE (n = 1 and 4, respectively). The proportion of the KPC-KP population represented by the ST258 clone increased from 120/184 (65%) in 2008 to 91/113 (80%) in 2013. In 58% (71/122) of the KPC-CPE carriers identified in the 2013 survey, the source of acquisition was determined to be the PACH itself. All four OXA-48 CPE were acquired either directly or indirectly from patients arriving from the Palestinian Authority or Syria. Conclusions: Despite the decreased prevalence of CPE in Israeli PACHs, and the emergence of new types of CPE, the KPC-KP ST258 clone remains the predominant clone represented.
KW - Clonal structure
KW - Colonization
KW - KPC
UR - http://www.scopus.com/inward/record.url?scp=84928331530&partnerID=8YFLogxK
U2 - 10.1093/jac/dku333
DO - 10.1093/jac/dku333
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C2 - 25204343
AN - SCOPUS:84928331530
SN - 0305-7453
VL - 70
SP - 89
EP - 92
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 1
ER -