Hypervirulent Klebsiella pneumoniae of Lineage ST66-K2 Caused Tonsillopharyngitis in a German Patient

Klaper, Kathleen; Wendt, Sebastian; Lübbert, Christoph; Lippmann, Norman; Pfeifer, Yvonne; Werner, Guido

doi:10.3390/microorganisms9010133

Cited by 16 publications

(13 citation statements)

References 19 publications

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“…This result is consistent with those of our previous study in the ICU ( Zeng et al., 2021 ). Several studies have observed that hvKP over time has been susceptible to antibiotics and related mainly to community-acquired infections ( Klaper et al., 2021 ). However, there are reports where this has been reversed and hvKP with antibiotic resistance and involved in infections associated with hospital care are gradually beginning to appear ( Gu et al., 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Western Chongqing, China

Huang

Zhang

Zeng

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundThis study aimed to determine the molecular characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in a hospital in western Chongqing, southwestern China.MethodsA total of 127 unique CRKP isolates were collected from the Yongchuan Hospital of Chongqing Medical University, identified using a VITEK-2 compact system, and subjected to microbroth dilution to determine the minimal inhibitory concentration. Enterobacteriaceae intergenic repeat consensus polymerase chain reaction and multilocus sequence typing were used to analyze the homology among the isolates. Genetic information, including resistance and virulence genes, was assessed using polymerase chain reaction. The genomic features of the CRKP carrying gene blaKPC-2 were detected using whole-genome sequencing.ResultsST11 was the dominant sequence type in the homology comparison. The resistance rate to ceftazidime-avibactam in children was much higher than that in adults as was the detection rate of the resistance gene blaNDM (p < 0.0001). Virulence genes such as mrkD (97.6%), uge (96.9%), kpn (96.9%), and fim-H (84.3%) had high detection rates. IncF (57.5%) was the major replicon plasmid detected, and sequencing showed that the CRKP063 genome contained two plasmids. The plasmid carrying blaKPC-2, which mediates carbapenem resistance, was located on the 359,625 base pair plasmid IncFII, together with virulence factors, plasmid replication protein (rep B), stabilizing protein (par A), and type IV secretion system (T4SS) proteins that mediate plasmid conjugation transfer.ConclusionOur study aids in understanding the prevalence of CRKP in this hospital and the significant differences between children and adults, thus providing new ideas for clinical empirical use of antibiotics.

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Section: Discussionmentioning

confidence: 99%

Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Western Chongqing, China

Huang

Zhang

Zeng

et al. 2022

Front. Cell. Infect. Microbiol.

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“…Neither ST23-K1 isolate is part of a previously described and globally distributed CG23-I clade and, as such, neither contained the combination of yersiniabactin and colibactin biosynthetics genes observed in ICEKp10 (Fig S6) (18). KPN49 is part of a rarely described ST66-K2 lineage consistent with the recent global re-emergence of this clone (Fig S6) (56,59,60).…”

Section: Phylogenetic Analysis Of Bloodstream Isolates Containing Hvkp Pathogenicity Locimentioning

confidence: 55%

Genomic surveillance for multidrug-resistant or hypervirulentKlebsiella pneumoniaeamong bloodstream isolates at a United States academic medical center

Kochan¹,

Khalatyan²,

Cheung³

et al. 2020

Preprint

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Klebsiella pneumoniae is a major threat to human health worldwide. “Classical” K. pneumoniae (cKp) strains commonly cause multidrug-resistant (MDR) infections in debilitated patients residing in hospitals and long-term care facilities. In contrast, hypervirulent K. pneumoniae (hvKp) strains may cause invasive, community-acquired infections in otherwise healthy individuals. These highly virulent strains were first identified in Taiwan in 1986 and have since disseminated across the globe. The prevalence of hvKp has been well described in Southeast Asia, but is not well understood in the United States. In this work, 141 consecutive K. pneumoniae blood stream isolates were collected at Northwestern Memorial Hospital from 2015-2017. To screen this collection for hvKp, isolates were tested for the hypermucoviscous phenotype and the presence of aerobactin and salmochelin biosynthesis genes, biomarkers that have been used to distinguish hvKp from cKp. These biomarkers were identified in 12 (8.5%), 6 (4.3%), and 5 (3.5%) isolates, respectively. Whole genome sequencing was performed on the six isolates that contained aerobactin biosynthesis genes and demonstrated that these genes were contained on large plasmids. Five isolates contained plasmids nearly identical to previously described hvKp virulence plasmids while one was similar to a plasmid from a swine isolate of K. pneumoniae. These findings indicate that several non-clonal hvKp-like strains are present in the U.S.

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“…The Qubit dsDNA HS Assay Kit (Invitrogen) was used for DNA quantification. DNeasy extracted DNA was sequenced on a NextSeq2000 benchtop device (Illumina) as described before [ 14 ]. The short-read whole-genome sequencing data analysis workflow was performed as described before, including several steps for quality control [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Recurrent bacteremia with a hypermucoviscous Escherichia coli isolated from a patient with perihilar cholangiocarcinoma: insights from a comprehensive genome-based analysis

Neumann

Lippmann

Wendt

et al. 2022

Ann Clin Microbiol Antimicrob

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Background Escherichia coli (E. coli) is a common human pathogen, responsible for a broad spectrum of infections. Sites of infection can vary, but the hepato-biliary system is of particular concern due to the infection-associated formation of gallstones and the spread of pathogens from the bile ducts into the bloodstream. Case presentation The presented case is striking, as the detected isolate showed a positive string test. This hypermucoviscous phenotype is atypical for E. coli and a particular feature of hypervirulent Klebsiella pneumoniae (K. pneumoniae) variants. Objectives To provide new insights into the genomic background of an E. coli strain with an unusual hypermucoviscous phenotype using hybrid short- and long-read sequencing approaches. Results Complete hybrid assemblies of the E. coli genome and plasmids were done and used for genome based typing. Isolate 537–20 was assigned to the multilocus sequence type ST88 and serotype O8:H4. The strain showed a close relationship to avian pathogenic strains. Analysis of the chromosome and plasmids revealed the presence of several virulence factors, such as the Conserved Virulence Plasmidic (CVP) region on plasmid 537-20_1, including several iron acquisition genes (sitABCD, iroABCDEN, iucABCD, hbd) and the iutA gene encoding the receptor of the siderophore aerobactin. The hypermucoviscous phenotype could be caused by encapsulation of putative K. pneumoniae origin. Conclusions Hybrid sequencing enabled detailed genomic characterization of the hypermucoviscous E. coli strain, revealing virulence factors that have their putative origin in K. pneumoniae.

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Hypervirulent Klebsiella pneumoniae of Lineage ST66-K2 Caused Tonsillopharyngitis in a German Patient

Cited by 16 publications

References 19 publications

Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Western Chongqing, China

Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Western Chongqing, China

Genomic surveillance for multidrug-resistant or hypervirulentKlebsiella pneumoniaeamong bloodstream isolates at a United States academic medical center

Recurrent bacteremia with a hypermucoviscous Escherichia coli isolated from a patient with perihilar cholangiocarcinoma: insights from a comprehensive genome-based analysis

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