Machuca, JesusLopez-Cerero, LorenaFernandez-Cuenca, FelipeMora-Navas, LauraMediavilla-Gradolph, ConcepcionLopez-Rodriguez, InmaculadaPascual, Alvaro2023-01-252023-01-252018-12-21Machuca J, López-Cerero L, Fernández-Cuenca F, Mora-Navas L, Mediavilla-Gradolph C, López-Rodríguez I, et al. OXA-48-Like-Producing Klebsiella pneumoniae in Southern Spain in 2014-2015. Antimicrob Agents Chemother. 2018 Dec 21;63(1):e01396-18.http://hdl.handle.net/10668/13089The aim of this study was to characterize the population structure of 56 OXA-48-like-producing Klebsiella pneumoniae isolates, as well as extended-spectrum β-lactamase (ESBL) and carbapenemase genes, recovered in 2014 and 2015 from 16 hospitals in southern Spain. XbaI pulsed-field gel electrophoresis and multilocus sequence typing were performed to assess clonal relatedness. Representative isolates belonging to OXA-48-like-producing and CTX-M-15-coproducing pulsotypes were selected for characterization of blaOXA-48-like- and blaCTX-M-15-carrying plasmids by PCR-based replicon typing, IncF subtyping, whole-genome sequencing analysis, and typing of Tn1999 structures. Forty-three OXA-48-producing isolates (77%) were recovered from clinical samples and 13 from rectal swabs. All isolates showed ertapenem MIC values of ≥1 mg/liter, although 70% remained susceptible to imipenem and meropenem. Forty-nine isolates (88%) produced OXA-48, 5 produced OXA-245, and 2 produced OXA-181. Twenty-eight different pulsotypes (5 detected in more than 1 hospital) and 16 sequence types (STs) were found. The most prevalent clones were ST15 (29 isolates [52%]) and ST11 (7 isolates [13%]). Forty-five (80%) isolates were also blaCTX-M-15 carriers. The blaCTX-M-15 gene was mostly (82%) located on IncR plasmids, although ST15 and ST11 isolates also carried this gene on IncF plasmids. The composite transposon variant Tn1999.2-like was the most frequent. Among ST15 and ST11 isolates, different transposon variants were observed. The blaOXA-48 gene was mainly located on IncL plasmids, although IncM plasmids were also observed. The spread of OXA-48-like-producing K. pneumoniae in southern Spain is mainly due to ST15 and ST11 clones. Variation within clonal lineages could indicate different acquisition events for both ESBL and carbapenemase traits.enKlebsiella pneumoniaeOXA-48Southern SpainBacterial ProteinsCross InfectionElectrophoresis, Gel, Pulsed-FieldErtapenemGenome, BacterialHumansImipenemKlebsiella InfectionsKlebsiella pneumoniaeMeropenemMicrobial Sensitivity TestsMultilocus Sequence TypingPlasmidsSpainTransposasesWhole Genome Sequencingbeta-Lactamasesresearch article30323046Restricted AccessPlásmidosCélulas clonalesEspañaGenomaTipificación de secuencias MultilocusElectroforesis en gel de campo pulsado10.1128/AAC.01396-181098-6596PMC6325174https://europepmc.org/articles/pmc6325174?pdf=renderhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325174/pdf