Klebsiella pneumoniae Isolate from a New York City Hospital Belonging to Sequence Type 258 and Carrying bla KPC-2 and bla VIM-4

Abstract

ABSTRACT Among 69 of 139 (49.6%) carbapenem-nonsusceptible Enterobacteriaceae carrying bla KPC , 1 Klebsiella pneumoniae was also positive for bla VIM . The isolate belonged to sequence type 258 (ST258) and carried bla KPC-2 on a copy of Tn4401 a and bla VIM-4 on a class 1 integron. Genes were located on distinct plasmids belonging to Inc types A/C and FII. Elevated expression of the efflux pump AcrAB-TolC ( acrA , 15.3 times) and reduced expression of outer membrane protein genes ompK35 and ompK37 (0.16 and 0.081 times, respectively) associated with various amino acid alterations on OmpK37 were observed. The presence of two carbapenemases in ST258 K. pneumoniae is of great concern due to the ability of this organism to widely disseminate.