KPC: Klebsiella pneumoniae carbapenemase, main carbapenemase in Enterobacteriaceae

The dissemination of carbapenemase-producing Enterobacteriaceae is currently considered a serious clinical problem due to the failure in the treatment of infections produced by them. Among the carbapenemases, the enzyme KPC has spread worldwide and has been identified in the main enterobacterial species related with healthcare-associated infections, although Klebsiella pneumoniae is the predominant specie. The bla(KPC) gene is transported, mainly by the transposon Tn4401, detected in various enterobacterial species of different sequence types (ST) and geographical origin. In addition, new genetic platforms that are distinguished, from Tn4401 because of insertions or deletions of other genes have been described. Plasmids containing the bla(KPC) gene can be conjugative and mobilizable non-conjugative plasmids, and can carry other genetic determinants of resistance. The KPC-producing strains may have different levels of resistance to carbapenems, due to the involvement of additional mechanisms such as different expression levels of porins and efflux pumps associated with the production of extended spectrum beta-lactamases and/or AmpC. However, the carbapenemases, with KPC as the most common enzyme, provide higher levels of resistance.