<i>In Vivo</i> High Plasticity of Multi-Drug Resistant ST258 <i>Klebsiella pneumoniae</i>

García-Fulgueiras, Virginia; Magallanes, Carmen; Reyes, Victoria; Cayota, Camila; Galiana, Antonio; Vieytes, Mariela; Vignoli, Rafael; Márquez, Carolina

doi:10.1089/mdr.2020.0310

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…The Klebsiella pneumoniae ST258 clone shows high plasticity, leading to high genetic variability. 28 The above is supported by the 16 S rRNA gene phylogenetic analysis of this study, which shows high genetic diversity among the strains. Such diversity suggests that a process of in-hospital evolutionary divergence has occurred, as has been demonstrated in other studies.…”

Section: Discussionsupporting

confidence: 70%

Phenotypic and genotypic characteristics of carbapenemase- and extended spectrum β-lactamase-producing Klebsiella pneumoniae ozaenae clinical isolates within a hospital in Panama City

Acosta

Landires²,

Morán

et al. 2021

Therapeutic Advances in Infection

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Klebsiella pneumoniae spp ozaenae is a versatile bacterial species able to acquire antimicrobial resistance; the species presents a higher antimicrobial resistance profile compared to Klebsiella pneumoniae spp pneumoniae. Carbapenemase and extended spectrum β-lactamase (ESBL)-producing bacteria commonly arise in clinical settings where antimicrobial stewardship is limited. Our study aims to report the phenotypical and genetic characteristics of nosocomial Klebsiella pneumoniae spp ozaenae isolates associated with mortality collected from a tertiary-level hospital in Panama City. In October 2020, 11 consecutive multidrug-resistant Gram-negative isolates were recovered from secretions and blood cultures from hospitalized patients. Nearly 90% (10/11) of these patients died, and bacteria was obtained from six patients for investigation. Biochemical evaluation of the six isolates revealed the presence of multidrug-resistant Klebsiella pneumoniae spp ozaenae. Phenotypic evaluation indicated resistance to carbapenemase and EBSL. In contrast, genetic evaluation by PCR showed that only 30% (2/6) were resistant to CTX-M-1 (CTX-M group 1), whereas 60.7% (4/6) presented carbapenemase resistance genes, and 33.3% (2/6) presented New Delhi metallo-β-lactamase ( NDM) resistance genes. Klebsiella pneumoniae ST258 was identified in 83.3% (5/6) of the isolates. Phylogenetic analysis using 16S revealed low homology among the six isolates. These results suggest that antibiotic resistance genes may have been incorporated into these Klebsiella pneumoniae spp ozaenae isolates within the hospital environment. We recommend strengthening the antimicrobial stewardship program and antibiotic control policy, as well as heightened infection control and prevention measures, such as ward sanitation and increased hand washing frequency.

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Section: Discussionsupporting

confidence: 70%

Phenotypic and genotypic characteristics of carbapenemase- and extended spectrum β-lactamase-producing Klebsiella pneumoniae ozaenae clinical isolates within a hospital in Panama City

Acosta

Landires²,

Morán

et al. 2021

Therapeutic Advances in Infection

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“…Fluoroquinolone resistance was observed in seven isolates (29.2%), which carried the plasmid-encoded qnr gene, as previously described for CRKP isolates [56]. The multidrug efflux pump oqxAB gene was detected in all strains [57], while the aac(6 )-Ib-cr gene (which encodes an aminoglycoside acetyltransferase that modifies not only aminoglycosides but also fluoroquinolones) has been identified in 16 isolates, as previously described [56].…”

Section: Discussionsupporting

confidence: 70%

Genetic Characterization of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates in a Tertiary Hospital in Greece, 2018–2022

et al. 2023

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Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a serious public health issue. The study aimed to identify the antimicrobial resistance and accessory genes, the clonal relatedness, and the evolutionary dynamics of selected CRKP isolates recovered in an adult and pediatric intensive care unit of a tertiary hospital in Greece. Methods: Twenty-four CRKP isolates recovered during 2018–2022 were included in the study. Next-generation sequencing was performed using the Ion Torrent PGM Platform. The identification of the plasmid content, MLST, and antimicrobial resistance genes, as well as the comparison of multiple genome alignments and the identification of core genome single-nucleotide polymorphism sites, were performed using various bioinformatics software. Results: The isolates belonged to eight sequence types: 11, 15, 30, 35, 39, 307, 323, and 512. A variety of carbapenemases (KPC, VIM, NDM, and OXA-48) and resistance genes were detected. CRKP strains shared visually common genomic regions with the reference strain (NTUH-K2044). ST15, ST323, ST39, and ST11 CRKP isolates presented on average 17, 6, 16, and 866 recombined SNPs, respectively. All isolates belonging to ST15, ST323, and ST39 were classified into distinct phylogenetic branches, while ST11 isolates were assigned to a two-subclade branch. For large CRKP sets, the phylogeny seems to change approximately every seven SNPs. Conclusions: The current study provides insight into the genetic characterization of CRKP isolates in the ICUs of a tertiary hospital. Our results indicate clonal dispersion of ST15, ST323, and ST39 and highly diverged ST11 isolates.

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“…Interestingly, such reports were restricted to pandemic clones occurring in Asia, mainly in China mostly represented by the hypervirulent/multidrug resistant ST11-K64 [2]. Curiously, outside China, the only two reports of K. pneumoniae co-harbouring bla NDM-1 / bla KPC-2 were in the South America: in a pandemic ST258 strain in Uruguay [11] and in a new ST in Brazil, as found here for Kp199 [12]. The co-existence of NDM-1 and KPC-2 is a worrisome association since it accounts for increased carbapenem MICs due to the synergistic effect of both enzymes as observed previously [2].…”

Section: Resultsmentioning

confidence: 99%

Genomic insights on the potential role of the accessory genome in the emergence of a novel geographically restrictedK. pneumoniaelineage as a high-risk clone

Bighi,

Freitas,

Morgado

et al. 2024

Preprint

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Klebsiella pneumoniae causes life-threatening nosocomial infections and is featured by a remarkable propensity for multidrug resistance acquisition. Infections caused by multidrug-(MDR) and extensively drug-resistant (XDR) strains lead to a limitation of therapeutic options and an increase in persistent infections, and they are usually represented by high-risk lineages. Based on these features and their relevance to global public health, most of the studies focused on such high-risk clones, and little is known about the epidemiological and evolutionary dynamics of new/geographically restricted lineages. This study aimed to unveil the antimicrobial resistance and virulence genetic repertoire of a clinical XDR K. pneumoniae (Kp199) strain belonging to geographically-restricted ST, not linked to any known clonal complex. Its intrinsic (gyrA, parC, ramR, soxR and soxS mutations) and acquired resistome agreed with the observed XDR phenotype. An extensive arsenal of both antibiotic and heavy metal resistance genes was observed, as well as genes involved with resistance to several antiseptics currently used in clinical settings. The co-occurrence of blaKPC-2 and blaNDM-1 carbapenemase genes in Kp199 was an alarming finding since it could contribute to increased carbapenem resistance. Kp199 virulome was associated with bacterial survival and replication during infections. This study raises concern about a novel, geographically restricted K. pneumoniae lineage harbouring a huge resistome and virulome, which may strongly contribute to its successful establishment as an epidemic lineage. Therefore, our findings underscore the importance of vigilant surveillance and control measures to mitigate the threat posed by the potential emergence of new high-risk pandemic clones.

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In Vivo High Plasticity of Multi-Drug Resistant ST258 Klebsiella pneumoniae

Cited by 5 publications

References 19 publications

Phenotypic and genotypic characteristics of carbapenemase- and extended spectrum β-lactamase-producing Klebsiella pneumoniae ozaenae clinical isolates within a hospital in Panama City

Phenotypic and genotypic characteristics of carbapenemase- and extended spectrum β-lactamase-producing Klebsiella pneumoniae ozaenae clinical isolates within a hospital in Panama City

Genetic Characterization of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates in a Tertiary Hospital in Greece, 2018–2022

Genomic insights on the potential role of the accessory genome in the emergence of a novel geographically restrictedK. pneumoniaelineage as a high-risk clone

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