TABLE 2.
High-risk carbapenemase-producing Klebsiella pneumoniae clones defined according to combinations of sequence type/carbapenemase.
| High-risk clones (n) | Hospitals (n) | Geographical distribution* | Evolution trends (%) 2013→2019** |
Representation in bacteremia (%) | Carbapenemase genes (%) | Other prevalent acquired resistance genes (%) |
| ST307/OXA-48 (62) | 23 | Andalucía, Castilla La Mancha, Castilla y León, Extremadura, Cataluña, Galicia, Canarias, País Vasco, Comunidad Valenciana, Madrid | 1.4→16.4 | 14 | blaOXA–48 (100) | blaSHV–28 (95.1), blaCTX–M–15 (88.5), aac(6’)-Ib-cr (78.7), qnrB1 (78.7), ant(3’)-Ia (75.4), sul2 (73.8), blaOXA–1 (73.8), aph(3”)-Ib (73.8), aph(6)-Id (73.8), catB3 (73.8%), dfrA14 (73.8), aac(3)-IIa (72.1), blaTEM–1b (70.5). |
| ST11/OXA-48 (62) | 22 | Andalucía, Castilla La Mancha, Castilla y León, Cantabria, Cataluña, La Rioja, Canarias, País Vasco, Madrid | 24.1→16.4 | 12 | blaOXA–48 (100), | blaCTX–M–15 (96.7), blaSHV–182 (95.1), blaOXA–1 (60.7), aac(6’)-Ib-cr (63.9), catB3 (63.9), aac(3)-IIa (55.7), qnrB1-like (57.4). |
| ST512-ST258/KPC (52) | 10 | Andalucía, Castilla La Mancha, Comunidad Valenciana, Cataluña, Madrid | 0→13.8 | 24 |
blaKPC–3 (86.5) blaKPC–23 (13.5) |
blaSHV–182 (97.9), aph(3”)-Ia (95.8), blaOXA–9 (95.8), aac(6’)-Ib (93.8), ant(3’)-Ia (93.8), sul1 (93.8), dfrA12 (93.3), catA1 (91.7), dfrA12 (91.7), mphA (91.7), blaTEM–187 (64.6). |
| ST15/OXA-48 like (43) | 16 | Andalucía, Castilla La Mancha, Madrid, Aragón, Cataluña, Canarias, País Vasco, Galicia | 8.2→11.4 | 16 |
blaOXA–48 (93) blaOXA–245 (7) |
blaSHV–28 (100), ant(3’)-Ia (83.7), blaOXA–1 (74.4%), blaCTX–M–15 (72.1), aac(6’)-Ib-cr (76.7), catB3 (74.4), dfrA14 (74.4), aph(3”)-Ib (60.5), aph(6)-Id (58.1), sul2 (58.1), blaTEM–1b (53.5). |
| ST147/OXA-48 (22) | 10 | Andalucía, Cataluña, Galicia, País Vasco, Asturias, Navarra | 2.5→5.8 | 0 |
blaOXA–48 (95.5) blaOXA–505(4.5) |
ant(3’)-Ia (90.9), blaCTX–M–15 (86.4), blaSHV–67 (86.4), aac(6’)-Ib (72.7), AAR-2 (72.7), rmtF (63.6), qnrB1 (47.6), dfrA14 (68.2), mphA (63.6), dfrA12 (59.1), sul1 (59.1). |
| ST307/KPC-3 (15) | 4 | Madrid, Extremadura, Castilla La Mancha | 0→4 | 4 | blaKPC–3 (100) | blaCTX–M–15 (100), blaOXA–1 (100), blaOXA–9 (100), aac(6’)-Ib-cr (100), aac(3)-IIa (100), ant(3’)-Ia (100), aph(3”)-Ib (100), aph(6)-Id (100), catB3 (100), dfrA14 (100), blaSHV–67 (100), sul2 (100), qnrB1-like (71.4). |
| ST392/OXA-48 (14) | 11 | Andalucía, Castilla La Mancha, Madrid, Cataluña, Comunidad Valenciana, Galicia | 0→3.7 | 4 | blaOXA–48 (100). | blaSHV–67 (100), aph(3”)-Ib (92.9), aph(6)-Ib (92.9), sul2 (86.7), blaTEM1–b (85.7), blaCTX–M–15 (78.6), dfrA14 (50), qnrB1 (40), aac(6’)-Ib-cr (57.1), blaOXA–1 (50), catB3 (50). |
| ST147/NDM-1 (7) | 4 | Cataluña, Galicia | 0→1.9 | 2 | blaNDM–1 (100) | aadA1(100), ARR(100), blaCTX–M–1–group (85.7), blaSHV–67 (100), sul1 (100), aac(6’)-Ib (71.4), dfrA12 (71.4), dfrA14 (71.4), qnrB1 (71.4), rmtF1 (71.4), aph(3”)-lb (57.1), aph(6)-ld (57.1). |
*Autonomous Communities in which the high-risk clones were detected.
**Evolution trends detected based on the results of a previous Spanish study conducted in 2013 (Oteo et al., 2015) relative to the study in 2019.