ArticleAntimicrobial agents and chemotherapy2016
A Two-Year Surveillance in Five Colombian Tertiary Care Hospitals Reveals High Frequency of Non-CG258 Clones of Carbapenem-Resistant Klebsiella pneumoniae with Distinct Clinical Characteristics.
Article in Antimicrobial agents and chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 1 of them a synthesis that pooled it.
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63 citing papers in PubMed, 1 synthesis or guideline pooled it, 119 citations in OpenAlex.
- Emergence and rapid global dissemination of CTX-M-15-associated Klebsiella pneumoniae strain ST307.The Journal of antimicrobial chemotherapy · 2019Pooled it
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- Plasmid-mediated carbapenem resistance: global dissemination patterns and replicon-gene associations.International microbiology : the official journal of the Spanish Society for Microbiology · 2025Article
- Epidemiological Genomics of Klebsiella pneumoniae isolates from hospitals across Colombia.npj antimicrobials and resistance · 2025Article
- Global Epidemiology and Antimicrobial Resistance of Klebsiella Pneumoniae Carbapenemase (KPC)-Producing Gram-Negative Clinical Isolates: A Review.Microorganisms · 2025Review
- Clonal dissemination and persistence of Carbapenem-resistantJAC-antimicrobial resistance · 2025Article
- Whole Genome Sequencing Analysis ofOpen forum infectious diseases · 2025Article
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- First Detection of High-Level Aminoglycoside-ResistantAntibiotics (Basel, Switzerland) · 2024Article
- Genomic characterization of Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) strains circulating in three university hospitals in Northern Italy over three years.Antimicrobial resistance and infection control · 2024Article
- International and regional spread of carbapenem-resistant Klebsiella pneumoniae in Europe.Nature communications · 2024Article
- Molecular characterization and descriptive analysis of carbapenemase-producing Gram-negative rod infections in Bogota, Colombia.Microbiology spectrum · 2024Article
- First report of KPC variants conferring ceftazidime-avibactam resistance in Colombia: introducing KPC-197.Microbiology spectrum · 2024Article
- Outbreak of NDM-5-producingmSystems · 2024Article
- High activity and specificity of bacteriophage cocktails against carbapenem-resistantFrontiers in microbiology · 2024Article
- Emergence of Hyper-Epidemic Clones of Enterobacterales Clinical Isolates Co-Producing KPC and Metallo-Beta-Lactamases during the COVID-19 Pandemic.Pathogens (Basel, Switzerland) · 2023Article
- Global scenario of the RmtE pan-aminoglycoside-resistance mechanism: emergence of theMicrobial genomics · 2023Article
- Risk factors and mortality of carbapenem-resistant Klebsiella pneumoniae bloodstream infection in a tertiary-care hospital in China: an eight-year retrospective study.Antimicrobial resistance and infection control · 2022Article
- Molecular Genetic Epidemiology of an Emerging Antimicrobial-ResistantAntibiotics (Basel, Switzerland) · 2022Article
3 more citing papers are in PubMed but not listed here.
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7 authors at 3 institutions in 2 countries.
Funding
Abstract
The global spread of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has been largely associated with sequence type 258 (ST258) and its related variants (clonal group 258 [CG258]). Here we describe the molecular epidemiology of CR-Kp from five tertiary care hospitals in Medellín, the second largest city in Colombia. All CR-Kp-infected patients admitted from June 2012 to June 2014 were included (n = 193). Patients' clinical information was obtained from medical records. Carbapenemase KPC, VIM, IMP, NDM, and OXA-48 genes were detected by PCR. A CG258-tonB79 cluster-specific real-time PCR (targeting the multilocus sequence type [MLST] tonB79 allele), pulsed-field gel electrophoresis (PFGE), and MLST analysis were performed for typing. Remarkably, 62.2% (n = 120) of isolates were from STs unrelated to CG258 (non-CG258). KPC-3 predominated in CG258 isolates (86.3%), while KPC-2 prevailed in non-CG258 isolates (75.5%) (P < 0.001). Multidrug resistance (MDR) frequency was significantly higher in CG258 strains (91.4% versus 56.1%; P < 0.001). ST512 (a single-locus variant of ST258) is the main ST in CG258 (96.3%), and isolates in this group showed closely related pulsotype and similar resistance gene profiles, suggesting the clonal spread of this strain. In contrast, high heterogeneity of STs (34/54), including eight novel STs, was found in non-CG258 isolates. Among non-CG258 isolates, ST14 (13.3%; n = 16) and ST307 (14.2%; n = 17) were the most frequent, and they showed distinct molecular and clinical characteristics in comparison to CG258 isolates. Our results suggest that the dissemination of carbapenem resistance in Medellín is due to heterogeneous K. pneumoniae clones, likely the result of horizontal transmission of KPC in different unrelated lineages, further highlighting the challenge in CR-Kp infection control and the need for a multifocal intervention.
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