The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Case Report

Carbapenem Resistance via the blaKPC-2 Gene in Enterobacter cloacae Blood Culture Isolate

Authors: Andy Lo, MD, Rosemary Verrall, MT, John Williams, MD, Charles Stratton, MD, Phyllis Della-Latta, PhD, MSc, Yi-Wei Tang MD, PhD

Abstract

An Enterobacter cloacae blood culture isolate expressing carbapenem resistance via the Klebsiella pneumoniae carbapenemase KPC-2 gene is reported. To our knowledge, this is the first report of a nosocomial isolate with carbapenemase-mediated resistance causing infection in a patient from Tennessee.

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References

1. Paterson DL. Recommendation for treatment of severe infections caused by Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs). Clin Microbiol Infect 2000;6:460–463.
 
2. Nordmann P, Cuzon G, Naas T. The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis 2009;9:228–236.
 
3. Yigit H, Queenan AM, Anderson GJ, et al. Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 2001;45:1151–1161.
 
4. Tibbetts R, Frye JG, Marschall J, et al. Detection of KPC-2 in a clinical isolate of Proteus mirabilis and first reported description of carbapenemase resistance caused by a KPC beta-lactamase in P. mirabilis. J Clin Microbiol 2008;46:3080–3083.
 
5. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard-Tenth Edition. Wayne, PA, Clinical and Laboratory Standards Institute, 2008.
 
6. Lee K, Chong Y, Shin HB, et al. Modified Hodge and EDTA-disk synergy tests to screen metallo-beta-lactamase-producing strains of Pseudomonas and Acinetobacter species. Clin Microbiol Infect 2001;7:88–91.
 
7. Queenan AM, Bush K. Carbapenemases: the versatile beta-lactamases. Clin Microbiol Rev 2007;20:440–458.
 
8. Deshpande LM, Rhomberg PR, Sader HS, et al. Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: report from the MYSTIC Program (1999–2005). Diagn Microbiol Infect Dis 2006;56:367–372.
 
9. Walther-Rasmussen J, Høiby N. Class A carbapenemases. J Antimicrob Chemother 2007;60:470–482.
 
10. Gootz TD, Lescoe MK, Dib-Hajj F, et al. Genetic organization of transposase regions surrounding blaKPC carbapenemase genes on plasmids from Klebsiella strains isolated in a New York City hospital. Antimicrob Agents Chemother 2009;53:1998–2004.
 
11. Villegas MV, Lolans K, Correa A, et al; Colombian Nosocomial Resistance Study Group. First identification of Pseudomonas aeruginosa isolates producing a KPC-type carbapenem-hydrolyzing beta-lactamase. Antimicrob Agents Chemother 2007;51:1553–1555.
 
12. Centers for Disease Control and Prevention (CDC). Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. MMWR Morb Mortal Wkly Rep 2009;58:256–260.