Cocarriage of Distinct
 bla
 KPC-2
 and
 bla
 OXA-48
 Plasmids in a Single Sequence Type 11 Carbapenem-Resistant Klebsiella pneumoniae Isolate

Wang, Yao-Chen; Tang, Huiling; Liao, Yu-Chieh; Chiou, Chien-Shun; Chen, Ying-Tsong; Chiang, Ming-Ko; Lu, Min-Chi; Lai, Yi‐Chyi

doi:10.1128/aac.02282-18

Cited by 17 publications

(9 citation statements)

References 9 publications

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“…Interestingly, there are eleven isolates in this study that carried two different types of carbapenemase genes, three of them were from 2015. The uncommon co-carriage of genes encoding different classes of carbapenemases genes were already described in the literature and reported in the western region of Saudi Arabia [35–38]. As migration and population mobility are increasingly important determinants of infection transmission, these issues will require greater policy attention at the multilateral level.…”

Section: Discussionmentioning

confidence: 98%

mCIM test as a reliable assay for the detection of CRE in the Gulf region

Musawi

Rahman

Aljaroodi

et al. 2021

Journal of Medical Microbiology

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Introduction. Carbapenem resistant Enterobacterales (CRE) are one of the leading causes of systemic and nosocomial infections and are multidrug-resistant organisms producing different carbapenemases. There are many genotypic and phenotypic methods for detecting the carbapenemases; however, there is a limitation for each. Modified carbapenem inactivation method (mCIM) assay is a recent phenotypic method which has been published by the Clinical and Laboratory Standards Institute. Hypothesis / Gap Statement. mCIM assay could provide a reliable method for the detection of carbapenemases in CRE. Aim. Evaluation of the mCIM assay performance for the detection of carbapenemases in Enterobacterales and the identification of the common carbapenemase genes at Eastern Province of Saudi Arabia and Kingdom of Bahrain. Methodology. A collection of 197 non-duplicate carbapenem resistant Enterobacterales clinical isolates, were evaluated with the mCIM test comparing its performance to multiplex PCR. The minimum inhibitory concentration susceptibility testing was done by the Etest method for imipenem, meropenem, and ertapenem. Results. The sensitivity of the mCIM assay was 94 % (95 % CI, (89.3–97.1)). In Saudi Arabia and Bahrain, OXA-48 was the most prevalent carbapenemase gene followed by NDM. Coexistence of multiple carbapenemase genes is reported in eleven cases. Conclusion. These findings indicate that the mCIM test is a reliable and simple assay for detecting the activity of carbapenemase in Enterobacterales , especially in resource-limited laboratories.

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Section: Discussionmentioning

confidence: 98%

mCIM test as a reliable assay for the detection of CRE in the Gulf region

Musawi

Rahman

Aljaroodi

et al. 2021

Journal of Medical Microbiology

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“…The most prevalent ST was ST101 (13/34 [38.2%]), followed by ST383 (5/34 [14.7%]). One isolate, EBSI036, belongs to ST11: ST11 is the dominant ST clone responsible for the prevalence of CRKP worldwide and is considered an emerging high-risk clone (1,(8)(9)(10). Among 31 CRKP isolates, the prevalence of carbapenemase genes bla NDM-1 and bla OXA-48 was 45.2% (14/31)-in addition, four strains carried both genes.…”

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confidence: 99%

Emergence of Hypervirulent Carbapenem-Resistant Klebsiella pneumoniae Coharboring a bla _NDM-1 -Carrying Virulent Plasmid and a bla _KPC-2 -Carrying Plasmid in an Egyptian Hospital

Ahmed

Yang

et al. 2021

mSphere

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The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in Egyptian hospitals has been reported. However, the genetic basis and analysis of the plasmids associated with carbapenem-resistant hypervirulent K. pneumoniae (CR-HvKP) in Egypt have not been presented. Therefore, we attempted to decipher the plasmid sequences that are responsible for transferring the determinants of carbapenem resistance, particularly blaNDM-1 and blaKPC-2. Out of 34 K. pneumoniae isolates collected from two tertiary hospitals in Egypt, 31 were CRKP. Whole-genome sequencing revealed that our isolates were related to 13 different sequence types (STs). The most prevalent ST was ST101, followed by ST383 and ST11. Among the CRKP isolates, one isolate named EBSI036 has been reassessed by Nanopore sequencing. Genetic environment analysis showed that EBSI036 carried 20 antibiotic resistance genes and was identified as a CR-HvKP strain: it harbored four plasmids, namely, pEBSI036-1-NDM-VIR, pEBSI036-2-KPC, pEBSI036-3, and pEBSI036-4. The two carbapenemase genes blaNDM-1 and blaKPC-2 were located on plasmids pEBSI036-1-NDM-VIR and pEBSI036-2-KPC, respectively. The IncFIB:IncHI1B hybrid plasmid pEBSI036-1-NDM-VIR also carried some virulence factors, including the regulator of the mucoid phenotype (rmpA), the regulator of mucoid phenotype 2 (rmpA2), and aerobactin (iucABCD and iutA). Thus, we set out in this study to analyze in depth the genetic basis of the pEBSI036-1-NDM-VIR and pEBSI036-2-KPC plasmids. We report a high-risk clone ST11 KL47 serotype of a CR-HvKP strain isolated from the blood of a 60-year-old hospitalized female patient from the intensive care unit (ICU) in a tertiary care hospital in Egypt, which showed the cohabitation of a novel hybrid plasmid coharboring the blaNDM-1 and virulence genes and a blaKPC-2-carrying plasmid. IMPORTANCE CRKP has been registered in the critical priority tier by the World Health Organization and has become a significant menace to public health. The emergence of CR-HvKP is of great concern in terms of both disease and treatment. In-depth analysis of the carbapenemase-encoding and virulence plasmids may provide insight into ongoing recombination and evolution of virulence and multidrug resistance in K. pneumoniae. Thus, this study serves to alert contagious disease clinicians to the presence of hypervirulence in CRKP isolates in Egyptian hospitals.

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“…Over 90% of ST11_KL64 and ST11_KL47 K. pneumoniae carried at least one carbapenemase-coding gene, while less than 30% of ST11_KL105 were carbapenemase-positive (Supplemental Figure S1b). Because KL64 and KL47 were the dominant ST11 sub-lineages, we selected KPC160111 (ST11_KL47) and KPC160132 (ST11_KL64), which had been completely sequenced in our previous studies, 26 , 27 as the representative strains of ST11 K. pneumoniae for the subsequent experiments.…”

Section: Resultsmentioning

confidence: 99%

Two ST11 Klebsiella pneumoniae strains exacerbate colorectal tumorigenesis in a colitis-associated mouse model

et al. 2021

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Sequence type (ST) 11 is one of the major lineages of carbapenem-resistant Klebsiella pneumoniae (CRKP). Although the gastrointestinal (GI) carriage of CRKP predisposes individuals to subsequent infections, little is known for its impact on gut homeostasis. In this study, we investigated the association between ST11 CRKP colonization and colorectal cancer (CRC). Two ST11 CRKP, KPC160111 (KL47) and KPC160132 (KL64), were selected as the representative strains. We used azoxymethane (AOM) and dextran sodium sulfate (DSS) to initiate a colitis-associated CRC model. Both strains established prolonged colonization in the GI tract of the AOM-DSS-treated BALB/c mice and aggravated gut dysbiosis. Under this AOM-DSS-induced setting, ST11 K. pneumoniae colonization significantly promoted the growth and progression of colorectal adenomas to high-grade dysplasia. Numerous crypts were formed inside the enlarged adenomas, in which CD163 + tumor-associated macrophages accumulated. Similarly, ST11 K. pneumoniae also increased the population size of the CD163 + macrophages with the M2 phenotype in the peritoneal cavity of LPS-primed BALB/c mice. When applied to RAW264.7 cells, ST11 K. pneumoniae polarized the macrophages toward an M2 phenotype through the inhibition of IKK-NFκB and the activation of STAT6-KLF4-IL-10. Through the M2-skewing ability, ST11 K. pneumoniae promoted the accumulation of CD163 + macrophages in the adenomatous crypts to create an immunosuppressive niche, which not only accommodated the extended stay for its own sake but also deteriorated colorectal tumorigenesis.

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Cocarriage of Distinct bla _KPC-2 and bla _OXA-48 Plasmids in a Single Sequence Type 11 Carbapenem-Resistant Klebsiella pneumoniae Isolate

Cited by 17 publications

References 9 publications

mCIM test as a reliable assay for the detection of CRE in the Gulf region

mCIM test as a reliable assay for the detection of CRE in the Gulf region

Emergence of Hypervirulent Carbapenem-Resistant Klebsiella pneumoniae Coharboring a bla _NDM-1 -Carrying Virulent Plasmid and a bla _KPC-2 -Carrying Plasmid in an Egyptian Hospital

Two ST11 Klebsiella pneumoniae strains exacerbate colorectal tumorigenesis in a colitis-associated mouse model

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Cocarriage of Distinct bla KPC-2 and bla OXA-48 Plasmids in a Single Sequence Type 11 Carbapenem-Resistant Klebsiella pneumoniae Isolate

Cited by 17 publications

References 9 publications

mCIM test as a reliable assay for the detection of CRE in the Gulf region

mCIM test as a reliable assay for the detection of CRE in the Gulf region

Emergence of Hypervirulent Carbapenem-Resistant Klebsiella pneumoniae Coharboring a bla NDM-1 -Carrying Virulent Plasmid and a bla KPC-2 -Carrying Plasmid in an Egyptian Hospital

Two ST11 Klebsiella pneumoniae strains exacerbate colorectal tumorigenesis in a colitis-associated mouse model

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Cocarriage of Distinct bla _KPC-2 and bla _OXA-48 Plasmids in a Single Sequence Type 11 Carbapenem-Resistant Klebsiella pneumoniae Isolate

Emergence of Hypervirulent Carbapenem-Resistant Klebsiella pneumoniae Coharboring a bla _NDM-1 -Carrying Virulent Plasmid and a bla _KPC-2 -Carrying Plasmid in an Egyptian Hospital