Virulence factors and clinical patterns of multiple-clone hypermucoviscous KPC-2 producing .

Carbapenemase-producing (CRKP) are increasingly reported worldwide being necessary the local epidemiological monitoring. Our aim was to characterize the hypermucoviscous CRKP isolates collected in our hospital during a 6 months period. Carriage of the carbapenemase genes ( , , and ), extended spectrum β-lactamases ( , ) and the virulence genes (A, k2A, A, G, , S, B, M, , G, H, D, A, N, and -1) were determined by multiplex-PCR. Genetic relationship among the isolates was performed by PFGE and MLST. A total of 35 isolates were recovered, being the urinary and respiratory tract the most common infection sites (34.2%). The gene was present in all the isolates, coexisting with (45.7%), (28.6%), and / (14.3%). The capsular serotype K2 corresponded with 68.6% of the isolates. Virulence factors frequency were variable [adhesins (97.1%), siderophores (94.3%) and phagocytosis resistance (G 48.5%, 80% and M 57.1%)]. A total of 10 STs were identified although 40% of them clustered on ST25-CC65, and 17% to ST17. The incidence of KPC-2-producing reported by the hospital was 0.290 per 1000 admissions. In summary we described an epidemic scenario of multidrug resistant hypermucoviscous KPC-2 producing ST25 in our institution.