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The rapidly increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) over the past decade has increased concern in healthcare facilities and the impact on public health. The prevalence of  bla  KPC  (KPC) in Thailand remains very low; only  bla  KPC-13  has been described previously. This study is the first to describe the characteristics of  bla  KPC-2 -carrying  Klebsiella pneumoniae ,  Escherichia coli , and  Enterobacter asburiae  in Thailand. The prevalence rate of  bla  KPC-2 -carrying isolates was 0.13% among CRE isolates in our study. Based on carbapenem susceptibility testing,  K. pneumoniae  C1985 was resistant to meropenem and ertapenem,  E. coli  C1992 was resistant to meropenem, imipenem, and ertapenem, and  E. asburiae  C2135 was only resistant to imipenem.  K. pneumoniae  C1985 carried  bla   KPC-2   , bla   SHV-11   , fosA, oqxA , and  oqxB , while  E. coli  C1992 contained  bla   KPC-2   and  mdf(A)  and  E. asburiae  C2135 harbored  bla   KPC-2   , bla   ACT-2  , and  qnrE1 . The genetic features of  bla  KPC-2  in the 3 isolates revealed identical rearrangement and flanking regions. Analysis of genomic sequences from these 3 isolates revealed that the sequence types of  K. pneumoniae  C1985,  E. coli  C1992, and  E. asburiae  C2135 were ST4008, ST7297, and ST1249, respectively. The 3  bla   KPC-2   isolates were from individual living cases. Two cases were colonization for  K. pneumoniae  C1985 and  E. asburiae  C2135 and the third case was hospital-acquired infection of  E. coli  C1992. Although the prevalence of  bla  KPC-2 -carrying CRE is relatively low in this study, continued surveillance and close monitoring are warranted. In addition, prompt or early detection of CRE and strict implementation of infection control are essential to prevent outbreaks or rapid spread in hospitals.

Genomic characterization of an emerging blaKPC-2 carrying Enterobacteriaceae clinical isolates in Thailand