A major concern is that routine susceptibility testing methods based on existing breakpoints can falsely identify KPC producers as susceptible to carbapenems.
In addition to detecting and identifying ESBL/KPC resistance in gastrointestinal tract infections caused by Enterobacteriaceae, Check-Point's ESBL/KPC DNA microarray has also been used to detect and identify KPC resistance in hospital-acquired pneumonia caused by Klebsiella pneumoniae [ 59].
In particular, we identified 35 KPC-KP strains in 2011 and 32 KPC-KP strains in 2012.
KPC-type PCR product (916 bp) obtained from K. pneumoniae M9171 was sequenced and identified as KPC-2 (1 ).
This ST has also been identified for KPC-producing K. pneumoniae in Sweden (in isolates imported from Greece and Israel) and more recently in Poland (36, 37 ).
ST14 has been identified among KPC-producing strains in the United States (38 ), and is associated with NDM-producing K. pneumoniae isolates in Kenya and the Sultanate of Oman (28 ), and as the most frequently encountered ST in a recent study of NDM-1 producing NDM-1 producingrom 3 countries (33 ).
All cases were tested to identify the KPC type; in 15 couples both isolates were KPC-3 and in one couple both strains were KPC-2, suggesting a persisting infection with the same strain.
The Vitek 2 system (bioMérieux. Firenze, Italy) was used for isolate identification and antimicrobial drug susceptibility testing; PCR and sequencing, as previously described, was used to identify bla KPC genes (3 ).
KPC, identified in 2001 (2 ), has become endemic to several noncontiguous areas of the world, including the United States, Israel, Greece, South America, and China (3 ).
Dominant carbapenemase from this group is KPC, identified in 1996 in North Caroline, USA, now causing many regional outbreaks, with endemicity in northeastern part of the USA, Israel, China, Porto Rico, Colombia, and Greece, and becoming more and more prevalent throughout Europe [ 4].
