Emergence of blaKPC-3-Tn4401a in Klebsiella pneumoniae ST512 in the municipal wastewater treatment plant and in the university hospital of a town in central Italy.

In this study, 20 carbapenem-resistant environmental Klebsiella pneumoniae strains were found to correlate with 18 clinical K. pneumoniae isolates from the teaching hospital of L'Aquila city, Italy. All strains analysed by multilocus sequence typing (MLST) were included in the same clone (ST512), and pulsed-field gel electrophoresis demonstrated a genetic relationship between the clinical isolates and most environmental strains. Both environmental and clinical strains harboured the same mobile genetic elements: transposon Tn4401a including a blaKPC-3 determinant; and a class 1 integron with the gene cassette aadA2.