KPC-producing Klebsiella pneumoniae (KPC-Kp) has become an important public health issue. The previous intestinal colonization by KPC-Kp has been an important risk factor associated with the progression to infections. The objective of this study was to assess the genetic characterization of KPC-Kp isolates recovered from human rectal swabs in Brazil. We selected 102 KPC-Kp isolates collected during 2009–2013 in 11 states. Antimicrobial susceptibility was determined by disk diffusion, E-test, and broth microdilution. The resistance and virulence genes were investigated by PCR. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). The isolates were mostly resistant to β-lactams, sulfonamides, chloramphenicol, quinolones, and aminoglycosides but susceptible to fosfomycin/trometamol, polymyxin B, and tigecycline. The bla_KPC-2 was mostly associated with Tn4401b. Besides that, the isolates carried bla_CTX-M, bla_SHV, bla_TEM, and aac(6′)-Ib in high frequency and aac(3′)IIa and qnr genes in moderate frequency. The PFGE revealed 26 pulsotypes and MLST performed in representative strains revealed 23 sequence types, 45% belonging to clonal complex 258 (CC258). Isolates of CC258 were found in all states. Seventy percent of the 102 KPC-Kp isolates belonged to CC258-associated pulsotypes. We describe the dissemination of KPC-2-Kp associated with Tn4401b belonging to CC258 colonizing patients in Brazil, which is also prevalent in infected patients, suggesting a clear colonization–infection correlation.

中文翻译：

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从监测直肠拭子分离的生产KPC-2的肺炎克雷伯菌的种群结构。

产生KPC的肺炎克雷伯菌（KPC- Kp）已成为重要的公共卫生问题。先前由KPC- Kp引起的肠道菌落已经成为与感染进展相关的重要危险因素。这项研究的目的是评估从巴西人直肠拭子中回收的KPC- Kp分离株的遗传特征。我们选择了102 KPC- Kp2009年至2013年期间在11个州收集的分离株。通过圆盘扩散，E检验和肉汤微稀释法确定抗菌药的敏感性。通过PCR研究抗性和毒力基因。分子分型是通过脉冲场凝胶电泳（PFGE）和多位点序列分型（MLST）进行的。分离株大多数对β-内酰胺，磺酰胺，氯霉素，喹诺酮和氨基糖苷具有耐药性，但对磷霉素/曲美他莫，多粘菌素B和替加环素敏感。所述BLA _KPC-2多数是与相关联的Tn的4401湾 除此之外，分离株还携带bla _CTX-M，bla _SHV，bla _TEM和aac（6'）-Ib在高频率中显示aac（3'）IIa和qnr基因。PFGE揭示了26种脉冲型，而在代表性菌株中进行的MLST揭示了23种序列类型，其中45％属于克隆复合体258（CC258）。在所有州都发现了CC258的分离株。102个KPC- Kp分离株中有70％属于CC258相关脉冲型。我们描述了与巴西CC258定植患者的Tn 4401 b相关的KPC-2- Kp的传播，这在受感染的患者中也很普遍，表明存在明显的定植与感染的相关性。