First Isolate of KPC-2-Producing Klebsiella pneumonaie Sequence Type 23 from the Americas

Cejas, Daniela; Canigia, Liliana Fernández; Cruz, Giovanna Rincón; Elena, Alan Xavier; Maldonado, Ivana; Gutkind, Gabriel; Radice, Marcela

doi:10.1128/jcm.00726-14

Cited by 63 publications

(48 citation statements)

References 19 publications

(22 reference statements)

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“…The presence of yersiniabactin in CC258, and also in the ESBL clones ST14 and ST15, is worrying, because our data show that it not only is strongly associated with infection in humans but also appears to be a frequent first step in the acquisition of additional siderophores that augment the ability of KpI clones to cause invasive non-hospital-related infections. There also is a high risk that current hypervirulent clones may acquire AMR, and MDR ST23 already has been reported in Korea, Vietnam, China, Madagascar, and Brazil (12,(61)(62)(63). Now that the associations have been recognized, new efforts can be more focused on the task of reconstructing the mobile elements that carry the critical virulence genes, ideally using long-read sequencing approaches that have proven successful for unraveling MDR plasmids (64).…”

Section: Resultsmentioning

confidence: 99%

Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae , an urgent threat to public health

Holt

Wertheim

Zadoks

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

966

1,123

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Klebsiella pneumoniae is now recognized as an urgent threat to human health because of the emergence of multidrug-resistant strains associated with hospital outbreaks and hypervirulent strains associated with severe community-acquired infections. K. pneumoniae is ubiquitous in the environment and can colonize and infect both plants and animals. However, little is known about the population structure of K. pneumoniae, so it is difficult to recognize or understand the emergence of clinically important clones within this highly genetically diverse species. Here we present a detailed genomic framework for K. pneumoniae based on whole-genome sequencing of more than 300 human and animal isolates spanning four continents. Our data provide genome-wide support for the splitting of K. pneumoniae into three distinct species, KpI (K. pneumoniae), KpII (K. quasipneumoniae), and KpIII (K. variicola). Further, for K. pneumoniae (KpI), the entity most frequently associated with human infection, we show the existence of >150 deeply branching lineages including numerous multidrug-resistant or hypervirulent clones. We show K. pneumoniae has a large accessory genome approaching 30,000 protein-coding genes, including a number of virulence functions that are significantly associated with invasive community-acquired disease in humans. In our dataset, antimicrobial resistance genes were common among human carriage isolates and hospital-acquired infections, which generally lacked the genes associated with invasive disease. The convergence of virulence and resistance genes potentially could lead to the emergence of untreatable invasive K. pneumoniae infections; our data provide the whole-genome framework against which to track the emergence of such threats.

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Section: Resultsmentioning

confidence: 99%

Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae , an urgent threat to public health

Holt

Wertheim

Zadoks

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

966

1,123

View full text Add to dashboard Cite

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“…bla KPC-2 was also discovered in the canonical hypervirulent K. pneumoniae ST23 [Cejas 2014]. Focused genomic analyses demonstrated that CG258 isolates cluster separately from ST23, and broader results confirm that multidrug resistant isolates have little overlap with hyper-virulent ones.…”

Section: Kpcmentioning

confidence: 93%

The rapid spread of carbapenem-resistant Enterobacteriaceae

Potter

D’Souza

Dantas

2016

Drug Resistance Updates

299

211

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Carbapenems, our one-time silver bullet for multidrug resistant bacterial infections, are now threatened by widespread dissemination of carbapenem-resistant Enterobacteriaceae (CRE). Successful expansion of Enterobacteriaceae clonal groups and frequent horizontal gene transfer of carbapenemase expressing plasmids are causing increasing carbapenem resistance. Recent advances in genetic and phenotypic detection facilitate global surveillance of CRE diversity and prevalence. In particular, whole genome sequencing enabled efficient tracking, annotation, and study of genetic elements colocalized with carbapenemase genes on chromosomes and on plasmids. Improved characterization helps detail the co-occurrence of other antibiotic resistance genes in CRE isolates and helps identify pan-drug resistance mechanisms. The novel β-lactamase inhibitor, avibactam, combined with ceftazidime or aztreonam, is a promising CRE treatment compared to current colistin or tigecycline regimens. To halt increasing CRE-associated morbidity and mortality, we must continue quality, cooperative monitoring and urgently investigate novel treatments.

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“…The development of resistant strains of hvKP demonstrates a need for avoiding unnecessary antibiotic use that stimulates the generation of resistant strains. This problem is emphasized by a cr-hvKP isolate obtained from an elderly man receiving chemotherapy who was previously treated because of another systemic infection before developing a fatal cr-hvKP infection [31]. The bacterial capsule is an important virulence factor and serotypes K1 and K2 have been particularly linked to severe bacteraemia and liver abscess [32,33].…”

Section: Discussionmentioning

confidence: 99%

Microbiological characteristics of hypermucoviscous Klebsiella pneumoniae isolates from different body fluids

Xiao

Yao

Zhou

et al. 2017

J Infect Dev Ctries

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Introduction: Reports of hypermucoviscous Klebsiella pneumoniae (hvKP) isolated from fluids other than blood or abscess are rare. The aim of the study was to compare clinical and microbiological characteristics of hvKP found in blood or abscess fluid with those isolated from other loci. Methodology: A total of 24 non-repetitive hvKP isolates were collected from January 2013 to June 2014 from patients with hvKP infections. There were 15 in Group 1 (fluid other than blood or abscess) and 9 in Group 2 (blood or abscess fluid). Medical records of all patients were reviewed. Capsular polysaccharide (CPS) typing, virulence factor determination, and multilocus sequence typing (MLST) of hvKP isolates were performed. Results: Seventeen sequence types (STs) and 6 capsular serotypes were identified. Type K2 CC65 was most commonly identified in Group 1 and type K2 CC86 in Group 2. Deletion of pLVPK-derived loci were found in K2 and non-K1/K2 hvKP strains. Two virulent genes, fimH and ycfM, were identified more frequently in Group 2 than in Group 1. There was no difference in the frequency of other virulent genes or serotypes in the two groups. Two imipenem resistant hvKP isolates (cr-hvKP) were found in non-blood or abscess samples. Conclusions: hvKP isolated from different body fluids had similar clinical and microbiological characteristics. cr-hvKP identified in non-blood or abscess samples should raise our attention to the challenging situation and management of hvKP infection.

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First Isolate of KPC-2-Producing Klebsiella pneumonaie Sequence Type 23 from the Americas

Cited by 63 publications

References 19 publications

Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae , an urgent threat to public health

Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae , an urgent threat to public health

The rapid spread of carbapenem-resistant Enterobacteriaceae

Microbiological characteristics of hypermucoviscous Klebsiella pneumoniae isolates from different body fluids

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