Clinical and molecular characteristics of multi-clone carbapenem-resistant hypervirulent (hypermucoviscous) Klebsiella pneumoniae isolates in a tertiary hospital in Beijing, China

Yao, Bei; Xiao, Xiumei; Wang, Fei; Zhou, Lei; Zhang, Xiaowei; Zhang, Jie

doi:10.1016/j.ijid.2015.06.023

Cited by 116 publications

(102 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, in this study we only found that one carbapenem-resistant HMKP isolate belonged to K2 (4.5%, 1/22). By contrast, Yao et al reported that 6 out of 7 carbapenem-resistant HMKP isolates belonged to K2 (Yao et al, 2015). Another Chinese study found that 5 carbapenem-resistant HMKP strains causing fatal infections belonged to K1.…”

Section: Discussionmentioning

confidence: 97%

“…HMKP is rarely resistant to commonly used antimicrobial agents except for an intrinsic resistance to ampicillin (Lin et al, 2010; Zhang et al, 2016). However, along with the dissemination of mobile genetic elements encoding carbapenemases, carbapenem-resistant HMKP isolates have been increasingly reported (Yang et al, 2014; Yao et al, 2015; Zhang, Y. et al, 2015). The emergence of carbapenem resistant, hypermucoviscous K. pneumoniae strains are of great concern as they may be capable of causing severe, untreatable infections in healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

Zhan

Wang

Guo

et al. 2017

Front. Cell. Infect. Microbiol.

134

View full text Add to dashboard Cite

Hypervirulent and multidrug resistant Klebsiella pneumoniae strains pose a significant threat to the public health. In the present study, 21 carbapenem-resistant K. pneumoniae isolates (CRKP) were determined by the string test as hypermucoviscous K. pneumoniae (HMKP), with the prevalence of 15.0% (21/140) among CRKP, and 1.1% (21/1838) among all K. pneumoniae isolates. Among them, 7 (33.3%), and 1 (4.76%) isolate belonged to capsular serotype K20 and K2 respectively, while 13 (61.9%, 13/21) weren't successfully typed by capsular serotyping. All the 21 isolates were carbapenemase-producers and were positive for blaKPC-2. In addition to blaKPC-2, all the 21 isolates except one harbor blaSHV-11, and 15 carry extended-spectrum β-lactamase gene blaCTX-M-65. The virulence-associated genes with more than 90% of positive rates among 21 isolates included ureA (100%, 21/21), wabG (100%, 21/21), fimH (95.2%, 20/21), entB (95.2%, 20/21), ycf (95.2%, 20/21), ybtS (95.2%, 20/21), and iutA (90.5%, 19/21). rmpA and aerobactin were found in 57.1% (12/21) isolates. Five sequence types (STs) were identified by multilocus sequence typing (MLST), including ST11 (11 K-non capsule typable and 5 K20 isolates), ST268 (1 K20 isolate and 1 K-non capsule typable isolate), ST65 (1 K2 isolate), ST692 (1 K-non capsule typable isolate), and ST595, a novel sequence type (1 K-non capsule typable isolate). Pulsed-field gel electrophoresis (PFGE) results showed two major PFGE clusters, of which cluster A accounts for 6 ST11 isolates (28.6%) and cluster B includes 8 ST11 isolates (38.1%, 8/21). Ten and six ST11 isolates were isolated from 2014 and 2015, respectively, while 8 were isolated from the same month of December in 2014. Ten isolates were collected from the intensive care unit (ICU), and all except one belonged to ST11. Additional 4 ST11 isolates were collected from patients in non-ICU wards, who had more than 10 days of ICU stay history in 2014 prior to transfer to their current wards where the isolates were recovered. Taken together, the present study showed a hospital outbreak and dissemination of ST11 HMKP with carbapenem resistance caused by KPC-2. Effective surveillance and strict infection control strategies should be implemented to prevent outbreak by HMKP with carbapenem resistance in hospitals.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

Zhan

Wang

Guo

et al. 2017

Front. Cell. Infect. Microbiol.

134

View full text Add to dashboard Cite

show abstract

“…In addition to the main high-risk clones, with respect to antimicrobial resistances, we also noticed isolates belonging to hypervirulent lineages: an ST23 isolate, two isolates belonging to ST65 (AMR0288 and AMR0296), and ST86 [22][23][24][25][26]. Whilst the ST23 isolate was submitted as urine isolate (AMR0157), one of the ST86 isolate (17-02612) encoding a high number of virulence factors is derived from a fatal meningitis case, and the lineage is closely related to the previously reported strain from a case in Guadeloupe [26], whilst a second ST86 isolate (AMR0062) seems to miss/have lost the virulence plasmid (Figure 4).…”

Section: Resultsmentioning

confidence: 99%

Caribbean multi-centre study of Klebsiella pneumoniae: whole genome sequencing, antimicrobial resistance and virulence factors

Heinz

Brindle

Morgan-McCalla

et al. 2019

Preprint

View full text Add to dashboard Cite

The surveillance of antimicrobial resistant isolates has proven to be one of the most valuable tools to understand the global rise of multidrug-resistant bacterial pathogens. We report the first insights into the current situation in the Caribbean, where a pilot project to monitor antimicrobial resistance through phenotypic resistance measurements combined with whole-genome sequencing was set up in collaboration with the Caribbean Public Health Agency (CARPHA). Our first study focused on Klebsiella pneumoniae, a highly relevant organism amongst the Gram-negative opportunistic pathogens world-wide today causing hospital, as well as community-acquired, infections. Our results show that not only carbapenem resistance, but also hypervirulent strains, are circulating in patients in the Caribbean. Our current data does not allow us to infer their prevalence in the population. We argue for the urgent need to further support antimicrobial resistance surveillance and stewardship in this almost uncharted territory, which can make a significant impact on the reduction of antimicrobial usage.

show abstract

“…Before the study of Danxia et al, there have been 36 CRHvKP strains isolated in China between 2010 and 2018 [13][14][15][16][17][18]. Sequence types and genotypes of β-lactamase (bla) genes of 36 strains were summarized in Table 1.…”

Section: The Analysis Of All Reported Cr-hvkp Strainsmentioning

confidence: 99%

The threat of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP)

Lee¹,

Park²,

Lee³

et al. 2018

biomedicalresearch

View full text Add to dashboard Cite

Klebsiella pneumoniae is one of clinically important opportunistic pathogens responsible for community-acquired and nosocomial infections in immunocompromised individuals. The increasing prevalence of carbapenem-resistant K. pneumoniae (CRKP) poses a serious threat to public health worldwide. With antibiotic resistance, hypervirulent K. pneumoniae (HvKP) responsible for serious disseminated infections in both healthy and immunocompromised individuals has also emerged. Recently, the emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-HvKP) strains has become a great challenge to public health. In this paper, we discuss the emergence mechanisms of CRHvKP through analyzing features of CR-HvKP strains isolated in China, where both CRKP and HvKP strains are prevalent. These analyses suggest that more extensive surveillance is required to accurately assess the potential threat of the plasmid-mediated convergence of carbapenem-resistance and hypervirulence.

show abstract

Clinical and molecular characteristics of multi-clone carbapenem-resistant hypervirulent (hypermucoviscous) Klebsiella pneumoniae isolates in a tertiary hospital in Beijing, China

Cited by 116 publications

References 36 publications

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

Caribbean multi-centre study of Klebsiella pneumoniae: whole genome sequencing, antimicrobial resistance and virulence factors

The threat of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP)

Contact Info

Product

Resources

About