Comparative population analysis of Klebsiella pneumoniae strains with extended-spectrum β-lactamases colonizing patients in rehabilitation centers in four countries

Abstract

The international project MOSAR was conducted in five rehabilitation centers; patients were screened for rectal carriage of extended-spectrum β-lactamase (ESBL)-producing members of the Enterobacteriaceae. Among 229 Klebsiella pneumoniae isolates, four clonal groups (CG) or complexes (CC) prevailed: CG17 in France, CG101 in Italy, CG15 in Spain, and CC147 in Israel. ESBLs, mainly CTX-Ms, were produced by 226 isolates; three isolates expressed AmpC-like cephalosporinases. High genetic diversity of K. pneumoniae populations was observed, with specific characteristics at each center.

Fig 1

Population structure of ESBL- or AmpC-producing K. pneumoniae isolates identified in the five rehabilitation centers (BM, FS, GI, LH, and TA), shown in the context of all of the 1,001 STs present in the global MLST database (http://www.pasteur.fr/mlst; as of2 August 2012). The scheme was constructed using eBURST analysis. STs are symbolized by dots; the STs identified in the study are represented by dots in circles. The size of a dot in circle corresponds to the number of isolates belonging to an ST. Single locus variants (SLVs) are linked by solid lines. Numbers indicate all of the CGs/CCs (and ST54) to which the STs identified in the study were classified. The STs which had only single SLVs in the database and singletons are not numbered.