Molecular characterization of clinical multidrug-resistant Klebsiella pneumoniae isolates

Cao, Xiaoli; Xu, Xuejing; Zhang, Zhifeng; Shen, Han; Chen, Junhao; Zhang, Kui

doi:10.1186/1476-0711-13-16

Cited by 60 publications

(43 citation statements)

References 29 publications

(29 reference statements)

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“…The extensive use of antimicrobials led to high incidence of resistance in K. pneumoniae 24. In our study, K. pneumoniae isolates showing multidrug resistance comprised 71.1% of total samples.…”

Section: Discussionmentioning

confidence: 64%

Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals

Wasfi

Elkhatib

Ashour

2016

Sci Rep

140

104

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Klebsiella pneumonia infection rates have increased dramatically. Molecular typing and virulence analysis are powerful tools that can shed light on Klebsiella pneumonia infections. Whereas 77.7% (28/36) of clinical isolates indicated multidrug resistant (MDR) patterns, 50% (18/36) indicated carpabenem resistance. Gene prevalence for the AcrAB efflux pump (82.14%) was more than that of the mdtK efflux pump (32.14%) in the MDR isolates. FimH-1 and mrkD genes were prevalent in wound and blood isolates. FimH-1 gene was prevalent in sputum while mrkD gene was prevalent in urine. Serum resistance associated with outer membrane protein coding gene (traT) was found in all blood isolates. IucC, entB, and Irp-1 were detected in 32.14%, 78.5% and 10.7% of MDR isolates, respectively. We used two Polymerase Chain Reaction (PCR) analyses: Enterobacterial Repetitive Intergenic Consensus (ERIC) and Random Amplified Polymorphic DNA (RAPD). ERIC-PCR revealed 21 and RAPD-PCR revealed 18 distinct patterns of isolates with similarity ≥80%. ERIC genotyping significantly correlated with resistance patterns and virulence determinants. RAPD genotyping significantly correlated with resistance patterns but not with virulence determinants. Both RAPD and ERIC genotyping methods had no correlation with the capsule types. These findings can help up better predict MDR Klebsiella pneumoniae outbreaks associated with specific genotyping patterns.

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Section: Discussionmentioning

confidence: 64%

Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals

Wasfi

Elkhatib

Ashour

2016

Sci Rep

140

104

View full text Add to dashboard Cite

show abstract

“…Other sequence types of KPC were also identified, for example, ST14 in Midwest United States6. Interestingly, ST11 is the predominant type of K. pneumonia associated with KPC production in China, which is closely related to ST258 and the latter is found more commonly elsewhere in the world2535. The overall mortality rate associated with KPC producing organisms is 50 per cent36.…”

Section: Epidemiologymentioning

confidence: 99%

A structural, epidemiological & genetic overview of Klebsiella pneumoniae carbapenemases (KPCs)

swathi

Chikala

et al. 2016

Indian J Med Res

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Klebsiella pneumoniae carbapenemases (KPCs) are plasmid encoded carbapenem hydrolyzing enzymes which have the potential to spread widely through gene transfer. The instability of upstream region of blaKPC accelerates emergence of different isoforms. Routine antibiotic susceptibility testing failed to detect KPC producers and some commercial kits have been launched for early identification of KPC producers. Notable among the drugs under development against KPC are mostly derivatives of polymixin; β-lactamase inhibitor NXL104 with combination of oxyimino cephalosporin as well as with ceftazidime; a novel tricyclic carbapenem, LK-157, potentially useful against class A and class C enzymes; BLI-489-a bicyclic penem derivative; PTK-0796, a tetracycline derivative and ACHN-490. Combination therapy might be preferable to control KPC infections in immediate future. Clinicians are likely to opt for unconventional combinations of antibiotics to treat KPC infections because of unavailability of alternative agents. The KPCs have become endemic in many countries but there is no optimal treatment recommendation available for bacteria expressing KPCs. Reports of outbreaks involving KPCs have focused mainly on laboratory identification, empirical treatment outcomes and molecular epidemiology. This review includes information on the emergence of KPC variants, limitations of phenotyping methods, available molecular methods for identification of the KPC variants and treatment options highlighting the drugs under development.

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“…Although the majority of infections occur among hospitalized patients with immuno-compromising and underlying illnesses, community-acquired infections are increasingly reported [3]. Carbapenem-resistant Enterobacteriaceae are resistant to multiple antibiotic classes and infections with these organisms often results in high mortality rates.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of the MicroScan®Walkaway System in Reporting Carbapenemase-Producing Enterobacteriaceae in Patients with Bacteremia, South Africa

Mohlabeng¹,

L²,

Perovic³

et al. 2017

J Antimicrob Agents

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Background: The emergence of Carbapenemase-producing Enterobacteriaceae (CPE) is a major public health problem worldwide. As Carbapenemase-production has emerged, treatment of infections has become more difficult leading to high mortality. Real time detection of the presence of these enzymes by in vitro susceptibility testing of these organisms is urgently needed to provide effective treatment and appropriate implementation of infection and prevention control measures. Automated phenotypic systems are widely used in clinical microbiology laboratories for bacterial identification and antimicrobial susceptibility testing. However, critical evaluation is needed to determine the accuracy of these systems.

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Molecular characterization of clinical multidrug-resistant Klebsiella pneumoniae isolates

Cited by 60 publications

References 29 publications

Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals

Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals

A structural, epidemiological & genetic overview of Klebsiella pneumoniae carbapenemases (KPCs)

The Efficacy of the MicroScan®Walkaway System in Reporting Carbapenemase-Producing Enterobacteriaceae in Patients with Bacteremia, South Africa

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