Ann Lab Med 2018; 38(4): 367-370  https://doi.org/10.3343/alm.2018.38.4.367
Phenotypic and Genomic Characterization of AmpC-Producing Klebsiella pneumoniae From Korea
Mattia Palmieri, M.Sc.1, Stephane Schicklin, Ph.D.2, Andreu Coello Pelegrin, M.Sc.1, Sonia Chatellier, Ph.D.1,*, Christine Franceschi, M.Sc.3, Caroline Mirande, Ph.D.3, Yeon-Joon Park, M.D.4, and Alex van Belkum, Ph.D.1
bioMérieux1, Data Analytics Unit, La Balme Les Grottes, France; bioMérieux2, Data Analytics Unit, Marcy l’Etoile, France; bioMérieux3, Clinical Unit, R&D Microbiology, La Balme Les Grottes, France; Department of Laboratory Medicine4, College of Medicine, Catholic University of Korea, Seoul, Korea
Corresponding author: Alex van Belkum
Data Analytics Unit, bioMérieux, 3 Route de Port Michaud, 38390 La Balme Les Grottes, France
Tel: +33609487905
E-mail: alex.vanbelkum@biomerieux.com
*Present address: Macopharma, 200, Chaussée Fernand Forest, 59200 – Tourcoing, France.
Received: October 30, 2017; Revised: November 14, 2017; Accepted: February 9, 2018; Published online: July 1, 2018.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The prevalence of multidrug-resistant gram-negative bacteria has continuously increased over the past few years; bacterial strains producing AmpC β-lactamases and/or extended-spectrum β-lactamases (ESBLs) are of particular concern. We combined high-resolution whole genome sequencing and phenotypic data to elucidate the mechanisms of resistance to cephamycin and β-lactamase in Korean Klebsiella pneumoniae strains, in which no AmpC-encoding genes were detected by PCR. We identified several genes that alone or in combination can potentially explain the resistance phenotype. We showed that different mechanisms could explain the resistance phenotype, emphasizing the limitations of the PCR and the importance of distinguishing closely-related gene variants.
Keywords: AmpC, Antibiotic resistance, Whole Genome Sequencing, Klebsiella pneumoniae, Korea



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