Molecular epidemiology of hypervirulent Klebsiella pneumoniae: a systematic review and meta-analysis

Sanikhani, Rahimeh; Moeinirad, Mohammad; Shahcheraghi, Fereshteh; Lari, Arezou; Fereshteh, Sepideh; Sepehr, Amin; Salimi, Afsaneh; Badmasti, Farzad

doi:10.18502/ijm.v13i3.6384

Cited by 13 publications

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“…This highlights the convergence of AMR genes and virulence genes among hospital and community hvKp isolates. Previous studies showed ST23 and ST11 as the predominant STs associated with hvKp infection and the evolution of MDR strains ( 20 ). However, in the present study, only one isolate was ST23, with the iucA , rmpA , and rmpA2 genes without any carbapenem resistance genes.…”

Section: Discussionmentioning

confidence: 91%

Comparative Analysis of Clinical and Genomic Characteristics of Hypervirulent Klebsiella pneumoniae from Hospital and Community Settings: Experience from a Tertiary Healthcare Center in India

et al. 2022

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Section: Discussionmentioning

confidence: 91%

Comparative Analysis of Clinical and Genomic Characteristics of Hypervirulent Klebsiella pneumoniae from Hospital and Community Settings: Experience from a Tertiary Healthcare Center in India

et al. 2022

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“…In a meta-analysis conducted by Sanikhani et al . [ 40 ] the rate of reported hypervirulent K. pneumoniae isolates was determined 21.7% globally which majority of them were from China. In our study, P35 and P38 carried non-conjugative hypervirulence plasmids belonging to repB plasmid replicon type and considered as MDR-hypervirulent strains.…”

Section: Discussionmentioning

confidence: 99%

Comparative genome analysis of colistin-resistant OXA-48-producing Klebsiella pneumoniae clinical strains isolated from two Iranian hospitals

Bolourchi

Shahcheraghi

Giske

et al. 2021

Ann Clin Microbiol Antimicrob

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Background Carbapenemase-producing Klebsiella pneumoniae (CP-KP) is becoming extensively disseminated in Iranian medical centers. Colistin is among the few agents that retains its activity against CP-KP. However, the administration of colistin for treatment of carbapenem-resistant infections has increased resistance against this antibiotic. Therefore, the identification of genetic background of co-carbapenem, colistin-resistance K.pneumoniae (Co-CCRKp) is urgent for implementation of serious infection control strategies. Methods Fourteen Co-CCRKp strains obtained from routine microbiological examinations were subjected to molecular analysis of antimicrobial resistance (AMR) using whole genome sequencing (WGS). Results Nine of 14 K.pneumoniae strains belonged to sequence type (ST)-11 and 50% of the isolates had K-locus type 15. All strains carried blaOXA-48 except for P26. blaNDM-1 was detected in only two plasmids associated with P6 and P26 strains belonging to incompatibility (Inc) groups; IncFIB, IncHI1B and IncFII. No blaKPC, blaVIM and blaIMP were identified. Multi-drug resistant (MDR) conjugative plasmids were identified in strains P6, P31, P35, P38 and P40. MICcolistin of K. pneumoniae strains ranged from 4 to 32 µg/ml. Modification of PmrA, PmrB, PhoQ, RamA and CrrB regulators as well as MgrB was identified as the mechanism of colistin resistance in our isolates. Single amino acid polymorphysims (SAPs) in PhoQ (D150G) and PmrB (R256G) were identified in all strains except for P35 and P38. CrrB was absent in P37 and modified in P7 (A200E). Insertion of ISKpn72 (P32), establishment of stop codon (Q30*) (P35 and P38), nucleotides deletion (P37), and amino acid substitution at position 28 were identified in MgrB (P33 and P42). None of the isolates were positive for plasmid-mediated colistin resistance (mcr) genes. P35 and P38 strains carried iutA, iucD, iucC, iucB and iucA genes and are considered as MDR-hypervirulent strains. P6, P7 and P43 had ICEKp4 variant and ICEKp3 was identified in 78% of the strains with specific carriage in ST11. Conclusion In our study, different genetic modifications in chromosomal coding regions of some regulator genes resulted in phenotypic resistance to colistin. However, the extra-chromosomal colistin resistance through mcr genes was not detected. Continuous genomic investigations need to be conducted to accurately depict the status of colistin resistance in clinical settings.

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“…The study identified a significant association between health care-related female reproductive tract infections and a history of miscarriage (18). However, no association was found between HAIs and a history of preterm births (19).…”

Section: Discussionmentioning

confidence: 87%

Second-trimester miscarriage caused by recurrent Klebsiella pneumoniae infection: a case report

et al. 2022

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Background: Klebsiella pneumoniae (K. pneumoniae) can cause hospital-and community-acquired pneumonia, and urinary tract, wound, and blood infections. As there are few reports on K. pneumoniae infections in pregnancy and no treatment guidelines, diagnosis and treatment are difficult. The diagnosis and treatment require a bacterial culture to confirm the diagnosis. Therefore, the condition is often exacerbated due to a lack of timely medication.Case Description: We report a case of a pregnant woman with recurrent K. pneumoniae infection during pregnancy. The 40-year-old woman was admitted to hospital at 14 weeks gestation due to fever of unknown origin. She was treated with empiric antibiotics, and her fever resolved within 1 day. A blood culture showed K. pneumoniae infection. She was discharged after 11 days of treatment. However, 10 days later, she was re-hospitalized due to fever, and treated with cefoperazone sodium and sulbactam sodium. Her fever resolved within 1 day. A blood culture again showed K. pneumoniae infection. On day 5, she experienced chills and a miscarriage. Cervical secretions showed K. pneumoniae, and a placental examination revealed chorioamnionitis. The treatment was changed to meropenem, and the patient recovered within 2 weeks.Conclusions: When a fever of unknown origin occurs during pregnancy, one should be wary of K. pneumoniae recurrence or secondary infection, and use sensitive antibiotics early. When K. pneumoniae is cultivated, the course of treatment must be sufficient, and the source of infection must be actively searched to prevent secondary infections, such as kidney cysts, liver cysts, lung cysts, and community infections. Finding the cause and taking appropriate treatment can prevent the occurrence of adverse pregnancy and childbirth history.

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Molecular epidemiology of hypervirulent Klebsiella pneumoniae: a systematic review and meta-analysis

Cited by 13 publications

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Comparative Analysis of Clinical and Genomic Characteristics of Hypervirulent Klebsiella pneumoniae from Hospital and Community Settings: Experience from a Tertiary Healthcare Center in India

Comparative Analysis of Clinical and Genomic Characteristics of Hypervirulent Klebsiella pneumoniae from Hospital and Community Settings: Experience from a Tertiary Healthcare Center in India

Comparative genome analysis of colistin-resistant OXA-48-producing Klebsiella pneumoniae clinical strains isolated from two Iranian hospitals

Second-trimester miscarriage caused by recurrent Klebsiella pneumoniae infection: a case report

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