Emergence of New Non–Clonal Group 258 High-Risk Clones among Klebsiella pneumoniae Carbapenemase–Producing K. pneumoniae Isolates, France

• Published in: Emerging infectious diseases Vol. 26; no. 6; pp. 1212 - 1220
• Main Authors: Bonnin, Rémy A., Jousset, Agnès B., Chiarelli, Adriana, Emeraud, Cécile, Glaser, Philippe, Naas, Thierry, Dortet, Laurent
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.06.2020; Centers for Disease Control and Prevention
• Subjects: Antibiotics; Antimicrobial agents; Biochemistry, Molecular Biology; carbapenemase; Carbapenemase–Producing; Cloning; Deoxyribonucleic acid; DNA; Drug resistance; Emergence of New Non–Clonal Group 258 High-Risk Clones among; Enzymes; Epidemiology; Genes; Genomes; Genomics; Imipenem; Isolates, France; Klebsiella pneumoniae; KPC; Laboratories; Life Sciences; Meropenem; Molecular biology; Mutation; Pneumonia; ST147; ST307; Tigecycline; Whole genome sequencing; Greece; France; Portugal; Western Europe; Italy; United States > US; China; Europe; ST307; epidemiology; bacteria; antimicrobial resistance; whole-genome sequencing; nosocomial infections; ST147; carbapenemase; France; bacterial infections; Klebsiella pneumoniae; KPC
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid2606.191517

The worldwide spread of Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) isolates was reported to be caused by dissemination of 1 clonal complex (i.e., clonal group [CG] 258, which includes sequence types [STs] 258 and 512). We conducted whole-genome sequencing and epidemiologic analysis of all KPC-Kp isolates in France in 2018 and found that new successful high-risk clones of ST147, ST307, ST231, and ST383 are now the main drivers of bla genes. The bla genes were mostly carried by Tn4401a and Tn4401d structures and a new non-Tn4401 element. Our epidemiologic investigations showed that the emergence of these non-CG258 KPC-Kp isolates in France was linked to dissemination of these clones from Portugal. Thus, KPC-Kp epidemiology has changed in Europe, at least in several non-KPC-endemic countries of western Europe, such as France and Portugal, where CG258 is not the most prevalent clone.