Roh Kyoung Ho, Lee Chang Kyu, Sohn Jang Wook, Song Wonkeun, Yong Dongeun, Lee Kyungwon
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea.
Korean J Lab Med. 2011 Oct;31(4):298-301. doi: 10.3343/kjlm.2011.31.4.298. Epub 2011 Oct 3.
Carbapenem-resistant Klebsiella pneumoniae isolates producing K. pneumoniae carbapenemases (KPC) were first reported in the USA in 2001, and since then, this infection has been reported in Europe, Israel, South America, and China. In Korea, the first KPC-2-producing K. pneumoniae sequence type (ST) 11 strain was detected in 2010. We report the case of a patient with a urinary tract infection caused by KPC-2-producing K. pneumoniae. This is the second report of a KPC-2-producing K. pneumoniae infection in Korea, but the multilocus sequence type was ST258. The KPC-2-producing isolate was resistant to all tested β-lactams (including imipenem and meropenem), amikacin, tobramycin, ciprofloxacin, levofloxacin, and trimethoprim-sulfamethoxazole, but was susceptible to gentamicin, colistin, polymyxin B, and tigecycline. The KPC-2-producing isolate was negative to phenotypic extended-spectrum β-lactamase (ESBL) and AmpC detection tests and positive to modified Hodge test and carbapenemase inhibition test with aminophenylboronic acid.
2001年在美国首次报道了产肺炎克雷伯菌碳青霉烯酶(KPC)的耐碳青霉烯类肺炎克雷伯菌分离株,此后,欧洲、以色列、南美洲和中国均有该感染的报道。在韩国,2010年检测到首例产KPC-2的肺炎克雷伯菌序列型(ST)11菌株。我们报告了1例由产KPC-2的肺炎克雷伯菌引起的尿路感染患者病例。这是韩国第二例产KPC-2的肺炎克雷伯菌感染报告,但多位点序列型为ST258。产KPC-2的分离株对所有测试的β-内酰胺类药物(包括亚胺培南和美罗培南)、阿米卡星、妥布霉素、环丙沙星、左氧氟沙星和复方新诺明耐药,但对庆大霉素、黏菌素、多黏菌素B和替加环素敏感。产KPC-2的分离株对表型超广谱β-内酰胺酶(ESBL)和AmpC检测试验呈阴性,对改良Hodge试验和用氨基苯硼酸进行的碳青霉烯酶抑制试验呈阳性。