Distribution of virulence genes and genotyping of CTX-M-15-producing Klebsiella pneumoniae isolated from patients with community-acquired urinary tract infection (CA-UTI)

Ranjbar, Reza; Memariani, Hamed; Sorouri, Rahim; Memariani, Mojtaba

doi:10.1016/j.micpath.2016.10.002

Cited by 36 publications

(31 citation statements)

References 37 publications

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“…In agreement with the other reports, a high prevalence of virulence genes fimH, mrkD, kpn, and entB was observed in K. pneumoniae isolates [2,16] that indicated their important role in pathogenesis of these isolates. It was found that all isolates harboring magA were isolated from inpatients that in accordance with other studies suggest significant role of MagA in pathogenesis of K. pneumoniae in complicated or severe UTIs [17].…”

Section: Discussionsupporting

confidence: 92%

Antibiotic resistance, virulence and genetic diversity of Klebsiella pneumoniae in community- and hospital-acquired urinary tract infections in Iran

Eghbalpoor

Habibi

Azizi

et al. 2019

AMicr

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Klebsiella pneumoniae is among the most important causes of urinary tract infection (UTI). The aim of this study was to investigate the prevalence and correlation of antibiotic resistance with virulence characteristics and genetic diversity in K. pneumoniae isolated from UTIs in Iran. Phenotypic tests and antibiotic susceptibility were carried out on the isolates. Detection of the virulence and extendedspectrum β-lactamase (ESBL) genes was performed by polymerase chain reaction. Pulsed-field gel electrophoresis (PFGE) was used for exploring the genomic relatedness. Hemolysin, biofilm, and hypermucoviscosity formation were observed in 87.1%, 86.4%, and 12.1% of isolates, respectively. The antibiotic resistance rate of K. pneumoniae isolates ranged from 12.1% for meropenem to 100% for amoxicillin. The prevalence of virulence genes ranged from 1.4% for cnf-1 to 100% for mrkD, fimH, kpn, and entB genes. In this study, 91.7%, 33.3%, and 4.2% of phenotypically ESBL-producers were positive for bla CTX-M , bla TEM , and bla SHV genes, respectively. An association was observed between the presence of traT, fyuA, or cnf-1 genes with antibiotic resistance. Two clone types were obtained by PFGE that indicate different K. pneumoniae clones in community-and hospital-acquired UTIs. The findings of this study are valuable in development of treatment strategies against UTIs in Iran.

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Section: Discussionsupporting

confidence: 92%

Antibiotic resistance, virulence and genetic diversity of Klebsiella pneumoniae in community- and hospital-acquired urinary tract infections in Iran

Eghbalpoor

Habibi

Azizi

et al. 2019

AMicr

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“…(36), and Pereira et al (37), yet in accordance with 31.5% reported by Derakhshan et al (34), also significantly lower than 50% reported by Derakhshan et al (27). The resistant rate to aztreonam was significantly lower than 100%, 59%, and 92.5% reported by Derakhshan et al (27), Derakhshan et al (34), and Ranjbar et al (35), yet in accordance with 39% and 38.1% reported by Peerayeh et al (26) and Pereira et al (37), also, significantly higher than 30% reported by Liu et al (31). The resistance rate to ceftazidime was significantly higher than 31.3%, 51.1%, 35.8%, and 4.8% reported by Shahcheraghi et al (25), Peerayeh et al (28), Liu et al (31), and Pereira et al (37), yet significantly lower than 100%, 57%, 100%, and 49.7% reported by Derakhshan et al (27), Derakhshan et al (34), and Ranjbar et al (35).…”

Section: Discussionsupporting

confidence: 68%

“…The resistance rate to imipenem was significantly higher than 1.4% and 0.05% reported by Liu et al (31), and Derakhshan et al (34), and also reports of Shahcheraghi et al (25), Peerayeh et al (26), Derakhshan et al (27), Peerayeh et al (28), and Ranjbar et al (35), which reported no resistance to imipenem, yet significantly lower than 20.8% reported by Amraie et al (36). The resistance rate to ciprofloxacin was significantly lower than 44.4%, 37.1%, 42.5%, and 52.5% reported by Derakhshan et al 27 The resistance rate to nitrofurantoin was significantly lower than 40% and 71% reported by Ranjbar et al (35) and Amraie et al (36). The resistance rate to trimethoprimsulfamethoxazole was significantly lower than 39%, 55.5%, 39.3%, 50%, 51.5%, and 54% reported by Peerayeh (31).…”

Section: Discussionmentioning

confidence: 48%

Evaluation of Virulence Factors and Antibiotic Resistance Patterns in Clinical Urine Isolates of Klebsiella pneumoniae in Semnan, Iran

Moghadas

Kalantari²,

Sarfi

et al. 2018

Jundishapur J Microbiol

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Background: Klebsiella pneumoniae as an opportunistic pathogen can be the cause of a range of nosocomial and community-acquired infections. Many virulence factors help these bacteria overcome an immune system and cause various diseases. K1 and K2 capsular antigens, also magA, wcaG, and rmpA are well-known K. pneumoniae virulence factors. Klebsiella pneumoniae has been revealed to have the ability to acquire resistance to many antibiotics, which cause treatment failure. Objectives: This study aimed at determining the prevalence of magA, wcaG, rmpA, Capsular type K1, Capsular type K2, TEM, and SHV in K. pneumoniae isolates. Methods: A total of 173 non-duplicate K. pneumoniae isolates were collected from two different hospitals in Semnan, Iran, from urine specimens. Klebsiella pneumoniae was identified by conventional bacteriological tests. Disk diffusion test was performed according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Detection of virulence factors, TEM, and SHV gene was performed by specific primers.

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“…With respect to the ESBL genes, of which CTX-M type enzymes were reported as the most common type, 96% of CRKP isolates in our study harbored blaCTX-M-9, whereas only 1% contained the blaCTX-M-15 gene, which is by far the most prevalent CTX-M variant worldwide (Cantón et al, 2012). Much of this discrepancy is due to geographical area (Ranjbar et al, 2016), because blaCTX-M-9 and blaCTX-M-14, which belong to the CTX-M-9 group, were important CTX-M-positive strains in China (Cantón et al, 2012). On the other hand, among the carbapenemase genes, all the CRKP strains tested positive for bla KPC-2 while only one CRKP was positive for the metallo-carbapenemase gene bla IMP-1.…”

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology and Risk Factors of Carbapenem-Resistant Klebsiella pneumoniae Infections in Eastern China

et al. 2017

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Background: The increasing prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses an immediate threat to treatment worldwide. This retrospective study assessed the molecular epidemiology and determined the risk factors for and outcomes of CRKP infections in a general teaching hospital in Shanghai, China.Methods: From January 2013 to July 2015, 100 consecutive unique CRKP isolates isolated from hospitalized patients were collected. Isolates were screened for antibiotic resistance genes by polymerase chain reaction and molecular typing was performed by pulsed-field gel electrophoresis (PFGE). Patients infected with CRKP comprised the case group and were compared to the control group of patients infected with carbapenem-susceptible Klebsiella pneumoniae. Therapeutic effects were compared in the CRKP infection group.Results: Among the 100 CRKP isolates, the percentages of multidrug-resistant, extensively drug-resistant (XDR), and pandrug-resistant were 50.0, 50.0, and 0%, respectively. All the CRKP isolates produced KPC-2 and could be divided into 18 PFGE clusters (A–O) and 70 subtypes. No dominant intra-hospital PFGE type was detected using a cutoff of 80% similarity. The ratio of CRKP infection to colonization was 51 to 49. Risk factors correlated with CRKP infection included pulmonary disease (p = 0.038), ICU stay (p = 0.002), invasive ventilation (p = 0.009), blood transfusion (p = 0.028), parenteral nutrition (p = 0.004), sputum suction (p = 0.006), medical history of previous hospitalization (p = 0.022), exposure to antibiotics 90 days before infection (p = 0.030), and antibiotic exposure during hospital stay including carbapenems (p = 0.013), enzyme inhibitors (p = 0.021), nitroimidazoles (p = 0.029), and glycopeptides (p = 0.000). Multivariable analysis showed that sputum suction (odds ratio 3.090, 95% confidence intervals 1.004–9.518, p = 0.049) was an independent risk factor for CRKP infections. Patients infected with CRKP with longer carbapenems treatment course (p = 0.002) showed better outcome.Conclusion: This study showed the severity of CRKP infection in eastern China. Sputum suction was an independent risk factor for CRKP infection. Prolonged duration of treatment with carbapenems benefited the patients infected with CRKP.

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Distribution of virulence genes and genotyping of CTX-M-15-producing Klebsiella pneumoniae isolated from patients with community-acquired urinary tract infection (CA-UTI)

Cited by 36 publications

References 37 publications

Antibiotic resistance, virulence and genetic diversity of Klebsiella pneumoniae in community- and hospital-acquired urinary tract infections in Iran

Antibiotic resistance, virulence and genetic diversity of Klebsiella pneumoniae in community- and hospital-acquired urinary tract infections in Iran

Evaluation of Virulence Factors and Antibiotic Resistance Patterns in Clinical Urine Isolates of Klebsiella pneumoniae in Semnan, Iran

Molecular Epidemiology and Risk Factors of Carbapenem-Resistant Klebsiella pneumoniae Infections in Eastern China

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