ESBL-Producing Strain of Hypervirulent<i>Klebsiella pneumoniae</i>K2, France

Surgers, Laure; Boyd, Anders; Girard, Pierre‐Marie; Arlet, Guillaume; Decré, Dominique

doi:10.3201/eid2209.160681

Cited by 57 publications

(55 citation statements)

References 10 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…His travel history was positive for Brazil, where cases of infections due to K1 serotype K. pneumoniae have been described [17]. In Europe several cases have also been described, with many cases in France [18], [19]. When performing a Medline search using the terms ‘hypervirulent,’ ‘ Klebsiella pneumoniae ’ and ‘Germany,’ we found no case of severe infection published using these keywords.…”

Section: Discussionmentioning

confidence: 90%

First report of invasive liver abscess syndrome with endophthalmitis caused by a K2 serotype ST2398 hypervirulent Klebsiella pneumoniae in Germany, 2016

Pichler

Büchsel

Rossen

et al. 2017

New Microbes and New Infections

View full text Add to dashboard Cite

We report a case of severe infection with liver abscess and endophthalmitis caused by a hypervirulent Klebsiella pneumoniae strain in an immunocompetent German male patient without travel history to Asia. Phenotypic and molecular characterization showed high similarity to the reference genome NTUH-K2044 isolated in Asia. The isolate was assigned as ST2398 (clonal complex 66). The findings underline global spread of hypervirulent Klebsiella pneumoniae strains to Europe.

show abstract

Section: Discussionmentioning

confidence: 90%

First report of invasive liver abscess syndrome with endophthalmitis caused by a K2 serotype ST2398 hypervirulent Klebsiella pneumoniae in Germany, 2016

Pichler

Büchsel

Rossen

et al. 2017

New Microbes and New Infections

View full text Add to dashboard Cite

show abstract

“…To date the majority of hypervirulent K. pneumoniae have remained susceptible to antimicrobials [38,46] (except ampicillin). However, the last few years have seen increasing reports of "convergent" K. pneumoniae that are both hypervirulent (defined as strains carrying the iuc aerobactin locus) and MDR ESBL/CP either due to acquisition of an MDR plasmid by a hypervirulent strain [47][48][49][50][51] or by acquisition of a virulence plasmid by an MDR strain [49,[52][53][54][55][56]. The majority of these reports represent sporadic isolations.…”

Section: Introductionmentioning

confidence: 99%

Genomic surveillance for hypervirulence and multi-drug resistance in invasive Klebsiella pneumoniae from South and Southeast Asia

et al. 2020

View full text Add to dashboard Cite

Background: Klebsiella pneumoniae is a leading cause of bloodstream infection (BSI). Strains producing extendedspectrum beta-lactamases (ESBLs) or carbapenemases are considered global priority pathogens for which new treatment and prevention strategies are urgently required, due to severely limited therapeutic options. South and Southeast Asia are major hubs for antimicrobial-resistant (AMR) K. pneumoniae and also for the characteristically antimicrobial-sensitive, community-acquired "hypervirulent" strains. The emergence of hypervirulent AMR strains and lack of data on exopolysaccharide diversity pose a challenge for K. pneumoniae BSI control strategies worldwide. Methods: We conducted a retrospective genomic epidemiology study of 365 BSI K. pneumoniae from seven major healthcare facilities across South and Southeast Asia, extracting clinically relevant information (AMR, virulence, K and O antigen loci) using Kleborate, a K. pneumoniae-specific genomic typing tool. Results: K. pneumoniae BSI isolates were highly diverse, comprising 120 multi-locus sequence types (STs) and 63 Kloci. ESBL and carbapenemase gene frequencies were 47% and 17%, respectively. The aerobactin synthesis locus (iuc), associated with hypervirulence, was detected in 28% of isolates. Importantly, 7% of isolates harboured iuc plus ESBL and/or carbapenemase genes. The latter represent genotypic AMR-virulence convergence, which is generally considered a rare phenomenon but was particularly common among South Asian BSI (17%). Of greatest concern, we identified seven novel plasmids carrying both iuc and AMR genes, raising the prospect of co-transfer of these phenotypes among K. pneumoniae.Conclusions: K. pneumoniae BSI in South and Southeast Asia are caused by different STs from those predominating in other regions, and with higher frequency of acquired virulence determinants. K. pneumoniae carrying both iuc and AMR genes were also detected at higher rates than have been reported elsewhere. The study demonstrates how genomics-based surveillance-reporting full molecular profiles including STs, AMR, virulence and serotype locus information-can help standardise comparisons between sites and identify regional differences in pathogen populations.

show abstract

“…Since it was one of the first microorganisms to develop resistance to aminosides (Christensen and Korner, 1972), it has played a central role in the spread of antibiotic resistance. K. pneumoniae has also gained particular notoriety with the emergence of hypervirulent strains including multiresistant ones (Turton et al, 2018, Paczosa and Mecsas, 2016, Surgers et al, 2016. Despite the major therapeutic and clinical concerns with these microorganisms, few studies have examined their ability to produce biofilm and hence their potential for further dissemination.…”

Section: Introductionmentioning

confidence: 99%

Biofilm formation by ESBL-producing strains of Escherichia coli and Klebsiella pneumoniae

Surgers

Boyd

Girard

et al. 2019

International Journal of Medical Microbiology

Self Cite

View full text Add to dashboard Cite

Objectives: Biofilm production in extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae provides a favourable environment for the exchange of antibiotic-resistance genes and could facilitate widespread dissemination. We aimed to assess biofilm development in ESBL-producing E. coli and K. pneumoniae isolates and determine how development relates to microbiological characteristics and clinical outcomes. Methods: 147 ESBL-producing E. coli and 82 K. pneumoniae were genetically characterized. Biofilm formation was measured at 1.5, 4, 6, and 24 hours during culture in blood heart infusion using a microbead immobilization assay (BioFilm Ring test®). Results were given as biofilm formation index (BFI) with lower values indicating increased presence of biofilm (range=0-21). Results: In total, 57.1% of strains were strong producers of biofilm (BFI<2), whereas 13.4% lacked biofilm production (BFI >18). Standard biofilm production (BFI<7) was common in E. coli isolates (61.9%). For E. coli, biofilm production was less frequently observed in ST131 clones (p=0.03) but more frequently in strains harbouring toxin (p=0.008) or adhesin (p=0.008) virulence factor genes. Despite almost all K. pneumoniae having standard biofilm production (90.2%), there was a 2.4-times higher odds of observing biofilm in ST29/147/323 versus other ST-types (p=0.13). Patients with standard biofilm producing isolates were not at increased risk of transfer to intensive-care (odds-ratio=2.80, 95%CI=0.59-13.21) or death within 12-months (odds-ratio=1.61, 95%CI=0.75-3.43). Conclusion: In these ESBL-producing strains, biofilm production is linked to certain virulence factors in E. coli and is common in K. pneumoniae. Further exploration of whether biofilm production increases dissemination and risk of severe clinical outcomes is needed in larger collections of isolates.

show abstract

ESBL-Producing Strain of HypervirulentKlebsiella pneumoniaeK2, France

Cited by 57 publications

References 10 publications

First report of invasive liver abscess syndrome with endophthalmitis caused by a K2 serotype ST2398 hypervirulent Klebsiella pneumoniae in Germany, 2016

First report of invasive liver abscess syndrome with endophthalmitis caused by a K2 serotype ST2398 hypervirulent Klebsiella pneumoniae in Germany, 2016

Genomic surveillance for hypervirulence and multi-drug resistance in invasive Klebsiella pneumoniae from South and Southeast Asia

Biofilm formation by ESBL-producing strains of Escherichia coli and Klebsiella pneumoniae

Contact Info

Product

Resources

About