Epidemiology of Carbapenemase-Producing Klebsiella pneumoniae in a Hospital, Portugal

We aimed to provide updated epidemiologic data on carbapenem-resistant Klebsiella pneumoniae in Portugal by characterizing all isolates (N = 46) recovered during 2013-2018 in a 123-bed hospital in Lisbon. We identified bla(KPC-3)(n = 36), bla(OXA-181)(n = 9), and bla(GES-5)(n = 8) carbapenemase genes and observed co-occurrence of bla(KPC-3 )and bla(GES-5) in 7 isolates. A single GES-5-producing isolate co-produced the extended-spectrum beta-lactamase BEL-1; both corresponding genes were co-located on the same ColE1-like plasmid. The bla(OXA-181) gene was always located on an IncX3 plasmid, whereas bla(KPC-3) was carried on IncN, IncFII, IncFIB, and IncFIIA plasmid types. The 46 isolates were distributed into 13 pulsotypes and 9 sequence types. All isolates remained susceptible to ceftazidime/avibactam, but some exhibited reduced antimicrobial susceptibility (MIC = 3 mg/L).