Characterization of <i>bla</i> _KPC-2 -Harboring <i>Klebsiella pneumoniae</i> Isolates and Mobile Genetic Elements from Outbreaks in a Hospital in Ecuador

Resumen

<b><i>Aim:</i></b> To investigate the mobile genetic elements harboring <i>bla</i>_KPC gene in carbapenem-resistant <i>Klebsiella pneumoniae</i> recovered during a 6-month outbreak in a high-complexity hospital from Ecuador. <b><i>Results:</i></b> A total of 62 isolates belonging to ST258 <i>pilv-I</i>-positive (<i>n</i> = 45), ST25 serotype K2 (<i>n</i> = 8), ST348 (<i>n</i> = 6), ST42 (<i>n</i> = 1), ST196 (<i>n</i> = 1), and ST1758 (<i>n</i> = 1) were collected from intensive care unit (ICU), neurosurgery, burn unit, internal medicine, pneumology, and neurology. Pulsed-field gel electrophoresis analysis showed two major clusters of ST258 and ST25 related to bloodstream infections and pneumonia circulating in ICU. The PCR assay showed that in non-ST258 isolates, the <i>bla</i>_KPC-2 gene were located on the Tn<i>4401a</i> transposon inserted in the transferable pKpQIL-like IncFII_K2 plasmid; the whole-genome sequencing of ST258 clone showed two plasmids, the <i>bla</i>_KPC-2 gene was located on nonconjugative IncR plasmid, whereas the IncFIB/IncFII plasmid lacked ß-lactamase genes. We found an IncM plasmid in <i>bla</i>_KPC-2-harboring <i>Klebsiella pneumoniae</i> ST1758 clone. <b><i>Conclusions:</i></b> These findings highlight the presence of pKpQIL-like plasmids in non-ST258 and nonconjugative plasmids in ST258 isolates causing hospital outbreaks.