Session Type: ePosters
Session Title: ePosters
Authors(s): J. Eisfeld, J.B. Hans, J. Schauer, S.G. Gatermann, N. Pfennigwerth
Authors Affiliations(s): Ruhr-University Bochum, Germany
Background:
The worldwide spread and increase of multidrug-resistant Gramnegative bacteria represents a serious threat to public health. Particularly, the rapid dissemination of plasmid-borne resistance genes between these bacteria allows for swift adaptation to antibiotic therapy and enhances nosocomial outbreaks of multidrug-resistant isolates.
Here, we report the identification of a clinical Klebsiella pneumoniae isolate simultaneously producing three different carbapenemases.
Methods:Carbapenemase detection was performed by modified Hodge test, combined disk test with boronic acid and/or EDTA and PCR for carbapenemase genes. Further phenotypical characterization of the K. pneumoniae isolate was conducted by microdilution and disk diffusion (interpretation according to EUCAST). Whole-cell DNA was subjected to WGS on an Illumina MiSeq platform with 2 x 300 bp paired end reads and on a MinION instrument with an R9.4 flow cell. Genome hybrid assembly was performed using the SPAdes assembler and contigs were screened for the presence of known resistance and virulence genes using Kleborate.
Results:In 2019, a K. pneumoniae species was isolated from a rectal swab from a patient on a general ward in Southern Germany and sent to the German National Reference Laboratory for multidrug-resistant Gram-negative bacteria. The modified Hodge test was positive for imipenem, meropenem and ertapenem and only the combination of boronic acid and EDTA increased susceptibility of the isolate. Furthermore, the isolate was found to be resistant to colistin. PCR for carbapenemase genes confirmed the presence of blaKPC-3, blaNDM-1 and blaOXA-48. WGS data indicated the three carbapenemase genes to be located on plasmids. Further analysis of sequencing data using the Kleborate software confirmed that the K. pneumoniae isolate belongs to the sequencing type 512 (ST512) which is frequently associated with nosocomial outbreaks.
Conclusions:In this report, we describe the first clinical isolate simultaneously producing the three carbapenemases KPC-3, NDM-1 and OXA-48. The presence of these three carbapenemases in combination with further determinants for resistance to antibiotics such as colistin, aminoglycosides, quinolones and sulfonamides leads to an extensively drug-resistant isolate.
Session Type: ePosters
Session Title: ePosters
Authors(s): J. Eisfeld, J.B. Hans, J. Schauer, S.G. Gatermann, N. Pfennigwerth
Authors Affiliations(s): Ruhr-University Bochum, Germany
Background:
The worldwide spread and increase of multidrug-resistant Gramnegative bacteria represents a serious threat to public health. Particularly, the rapid dissemination of plasmid-borne resistance genes between these bacteria allows for swift adaptation to antibiotic therapy and enhances nosocomial outbreaks of multidrug-resistant isolates.
Here, we report the identification of a clinical Klebsiella pneumoniae isolate simultaneously producing three different carbapenemases.
Methods:Carbapenemase detection was performed by modified Hodge test, combined disk test with boronic acid and/or EDTA and PCR for carbapenemase genes. Further phenotypical characterization of the K. pneumoniae isolate was conducted by microdilution and disk diffusion (interpretation according to EUCAST). Whole-cell DNA was subjected to WGS on an Illumina MiSeq platform with 2 x 300 bp paired end reads and on a MinION instrument with an R9.4 flow cell. Genome hybrid assembly was performed using the SPAdes assembler and contigs were screened for the presence of known resistance and virulence genes using Kleborate.
Results:In 2019, a K. pneumoniae species was isolated from a rectal swab from a patient on a general ward in Southern Germany and sent to the German National Reference Laboratory for multidrug-resistant Gram-negative bacteria. The modified Hodge test was positive for imipenem, meropenem and ertapenem and only the combination of boronic acid and EDTA increased susceptibility of the isolate. Furthermore, the isolate was found to be resistant to colistin. PCR for carbapenemase genes confirmed the presence of blaKPC-3, blaNDM-1 and blaOXA-48. WGS data indicated the three carbapenemase genes to be located on plasmids. Further analysis of sequencing data using the Kleborate software confirmed that the K. pneumoniae isolate belongs to the sequencing type 512 (ST512) which is frequently associated with nosocomial outbreaks.
Conclusions:In this report, we describe the first clinical isolate simultaneously producing the three carbapenemases KPC-3, NDM-1 and OXA-48. The presence of these three carbapenemases in combination with further determinants for resistance to antibiotics such as colistin, aminoglycosides, quinolones and sulfonamides leads to an extensively drug-resistant isolate.
Session Type: ePosters
Session Title: ePosters
Authors(s): J. Eisfeld, J.B. Hans, J. Schauer, S.G. Gatermann, N. Pfennigwerth
Authors Affiliations(s): Ruhr-University Bochum, Germany
Background:
The worldwide spread and increase of multidrug-resistant Gramnegative bacteria represents a serious threat to public health. Particularly, the rapid dissemination of plasmid-borne resistance genes between these bacteria allows for swift adaptation to antibiotic therapy and enhances nosocomial outbreaks of multidrug-resistant isolates.
Here, we report the identification of a clinical Klebsiella pneumoniae isolate simultaneously producing three different carbapenemases.
Methods:Carbapenemase detection was performed by modified Hodge test, combined disk test with boronic acid and/or EDTA and PCR for carbapenemase genes. Further phenotypical characterization of the K. pneumoniae isolate was conducted by microdilution and disk diffusion (interpretation according to EUCAST). Whole-cell DNA was subjected to WGS on an Illumina MiSeq platform with 2 x 300 bp paired end reads and on a MinION instrument with an R9.4 flow cell. Genome hybrid assembly was performed using the SPAdes assembler and contigs were screened for the presence of known resistance and virulence genes using Kleborate.
Results:In 2019, a K. pneumoniae species was isolated from a rectal swab from a patient on a general ward in Southern Germany and sent to the German National Reference Laboratory for multidrug-resistant Gram-negative bacteria. The modified Hodge test was positive for imipenem, meropenem and ertapenem and only the combination of boronic acid and EDTA increased susceptibility of the isolate. Furthermore, the isolate was found to be resistant to colistin. PCR for carbapenemase genes confirmed the presence of blaKPC-3, blaNDM-1 and blaOXA-48. WGS data indicated the three carbapenemase genes to be located on plasmids. Further analysis of sequencing data using the Kleborate software confirmed that the K. pneumoniae isolate belongs to the sequencing type 512 (ST512) which is frequently associated with nosocomial outbreaks.
Conclusions:In this report, we describe the first clinical isolate simultaneously producing the three carbapenemases KPC-3, NDM-1 and OXA-48. The presence of these three carbapenemases in combination with further determinants for resistance to antibiotics such as colistin, aminoglycosides, quinolones and sulfonamides leads to an extensively drug-resistant isolate.
Session Type: ePosters
Session Title: ePosters
Authors(s): J. Eisfeld, J.B. Hans, J. Schauer, S.G. Gatermann, N. Pfennigwerth
Authors Affiliations(s): Ruhr-University Bochum, Germany
Background:
The worldwide spread and increase of multidrug-resistant Gramnegative bacteria represents a serious threat to public health. Particularly, the rapid dissemination of plasmid-borne resistance genes between these bacteria allows for swift adaptation to antibiotic therapy and enhances nosocomial outbreaks of multidrug-resistant isolates.
Here, we report the identification of a clinical Klebsiella pneumoniae isolate simultaneously producing three different carbapenemases.
Methods:Carbapenemase detection was performed by modified Hodge test, combined disk test with boronic acid and/or EDTA and PCR for carbapenemase genes. Further phenotypical characterization of the K. pneumoniae isolate was conducted by microdilution and disk diffusion (interpretation according to EUCAST). Whole-cell DNA was subjected to WGS on an Illumina MiSeq platform with 2 x 300 bp paired end reads and on a MinION instrument with an R9.4 flow cell. Genome hybrid assembly was performed using the SPAdes assembler and contigs were screened for the presence of known resistance and virulence genes using Kleborate.
Results:In 2019, a K. pneumoniae species was isolated from a rectal swab from a patient on a general ward in Southern Germany and sent to the German National Reference Laboratory for multidrug-resistant Gram-negative bacteria. The modified Hodge test was positive for imipenem, meropenem and ertapenem and only the combination of boronic acid and EDTA increased susceptibility of the isolate. Furthermore, the isolate was found to be resistant to colistin. PCR for carbapenemase genes confirmed the presence of blaKPC-3, blaNDM-1 and blaOXA-48. WGS data indicated the three carbapenemase genes to be located on plasmids. Further analysis of sequencing data using the Kleborate software confirmed that the K. pneumoniae isolate belongs to the sequencing type 512 (ST512) which is frequently associated with nosocomial outbreaks.
Conclusions:In this report, we describe the first clinical isolate simultaneously producing the three carbapenemases KPC-3, NDM-1 and OXA-48. The presence of these three carbapenemases in combination with further determinants for resistance to antibiotics such as colistin, aminoglycosides, quinolones and sulfonamides leads to an extensively drug-resistant isolate.