Occurrence and characterization of hyperviscous K1 and K2 serotype in Klebsiella pneumoniael

Remya, Poothakuzhiyil; Shanthi, M; Sekar, Uma

doi:10.4103/jlp.jlp_48_18

Cited by 38 publications

(33 citation statements)

References 22 publications

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“…Global dissemination of hvKp. Following early reports of hvKp in Asia, it is now apparent that hvKp has spread globally, including India [163,164], Europe [32,34,35,37,[165][166][167][168], Australia [169,170] and the United States [5,30,31,36,53,171,172] and healthcare providers worldwide should recognize the threat of community-acquired hvKp in otherwise healthy individuals. The rise of hospital-acquired hvKp which may manifest in different presentations, and the convergence of multidrug resistance (MDR) and virulence either in as well as bla SHV-1 and fosA [182] AR, antimicrobial resistance; bla, beta-lactamase provides resistance to penicillins, first-and second-generation cephalosporins; bla CTX-M-24, bla CTX-M-3 and bla CTX-M-4 , ESBLs with particular activity against cefotaxime; bla KPC-2, bla (K. pneumoniae carbapenem resistance) with carbapenemase activity; bla NDM-1 , bla (New Delhi metallo-bla) with carbapenemase activity; bla OXA-32 and bla OXA-9 , ESBLs with particular activity against oxacillin; bla SHV-36 and bla SHV-11 , ESBLs; bla TEM-1A, bla TEM-1, and bla TEM-53 , ESBLs; dfrA14, trimethoprim resistance gene; ESBL, extended-spectrum betalactamase provides additional resistance to monobactams and third-generation cephalosporins; fosA, fosfomycin resistance gene; kb, kilobase, length of DNA molecule; ompK35/36, outer membrane porins that allow entry carbapenems and cephalosporins, reduced expression increases resistance; oqxAB, resistance to olaquindox and some quinolones.…”

Section: Outstanding Questions and Outlookmentioning

confidence: 99%

“…Global dissemination of hvKp. Following early reports of hvKp in Asia, it is now apparent that hvKp has spread globally, including India , Europe , Australia and the United States and healthcare providers worldwide should recognize the threat of community‐acquired hvKp in otherwise healthy individuals. The rise of hospital‐acquired hvKp which may manifest in different presentations, and the convergence of multidrug resistance (MDR) and virulence either in cKp or hvKp strains, is particularly concerning.…”

Section: Outstanding Questions and Outlookmentioning

confidence: 99%

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Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives

2019

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Hypervirulent Klebsiella pneumoniae (hvKp) has emerged as a concerning global pathogen. hvKp is more virulent than classical K. pneumoniae (cKp) and capable of causing community‐acquired infections, often in healthy individuals. hvKp is carried in the gastrointestinal tract, which contributes to its spread in the community and healthcare settings. First recognized in Asia, hvKp arose as a leading cause of pyogenic liver abscesses. In the decades since, hvKp has spread globally and causes a variety of infections. In addition to liver abscesses, hvKp is distinct from cKp in its ability to metastasize to distant sites, including most commonly the eye, lung and central nervous system (CNS). hvKp has also been implicated in primary extrahepatic infections including bacteremia, pneumonia and soft tissue infections. The genetic determinants of hypervirulence are often found on large virulence plasmids as well as chromosomal mobile genetic elements which can be used as biomarkers to distinguish hvKp from cKp clinical isolates. These distinct virulence determinants of hvKp include up to four siderophore systems for iron acquisition, increased capsule production, K1 and K2 capsule types, and the colibactin toxin. Additionally, hvKp strains demonstrate hypermucoviscosity, a phenotypic description of hvKp in laboratory conditions that has become a distinguishing feature of many hypervirulent isolates. Alarmingly, multidrug‐resistant hypervirulent strains have emerged, creating a new challenge in combating this already dangerous pathogen.

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Section: Outstanding Questions and Outlookmentioning

confidence: 99%

Section: Outstanding Questions and Outlookmentioning

confidence: 99%

Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives

2019

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“…There are a number of virulence factors that contribute to the pathogenicity of K pneumoniae , including a hypermucoviscosity-specific capsular serotype, especially K1 or K2, and the virulence genes FimH , rmpA , uge , kfu , and alls . [2,3] K1 and K2 serotypes are more prevalent in invasive infections and are strongly associated with fatal outcomes. The invasive K pneumoniae strains were reported as having a hypermucoviscous phenotype associated with serotypes K1 and K2.…”

Section: Introductionmentioning

confidence: 99%

Klebsiella pneumoniae-induced multiple invasive abscesses

Wang

Zhang²,

Li³

et al. 2019

Medicine

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Rationale:Klebsiella pneumoniae infection can induce multiple invasive abscesses, and the invasive infection is severe and life-threatening.Patient concerns:A 69-year-old previously healthy Chinese male presented with fever, chill, backache, and ocular pain.Diagnosis:The blood culture results indicated Klebsiella pneumoniae of the K1 serotype. Multiple invasive abscesses in liver, lung, eye, soft tissue, and central nervous system were identified by imaging examination. Subsequently, the patient experienced right ocular pain accompanied by visual disturbance. Tyndall sign was strongly positive, and lens opacity was observed by the ophthalmologist.Interventions:Full-dose and long-term treatment with meropenem was performed. Intraventricular injection of glass and anterior chamber puncture with antibiotics were performed twice. The patient also underwent an evacuation of the brain abscess.Outcomes:The patient's headache and lumbar backache were relieved, his ophthalmodynia disappeared, and his vision recovered after nearly 3 months of treatment.Lessons:Imaging examination is very important for severe Klebsiella pneumoniae infection. The choice of antibiotics is complex, and the antimicrobial regimen should be adjusted according to the assessment of illness and the therapeutic effect. Surgical intervention must be considered for patients with multiple invasive abscesses.

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“…Among the 11 Klebsiella isolates belonging to K2 serotype, two isolates were found to carry carbapenem resistance genes, bla OXA-181 and bla GES-9 (Table 4). In India, NDM-1 and OXA-48 genes were detected in Klebsiella belonging to K2 serotypes [40], but to the best of our knowledge, this is the first study to detect the presence of carbapenemase genes NDM-1, OXA-181 and OXA-51 among K1 serotypes.…”

Section: Discussionmentioning

confidence: 76%

“…The Klebsiella belonging to K-serotypes have K-antigen that relates to the capsule polysaccharide (CPS) [39]. Of the known capsular types (eight serotypes), the serotypes K1 and K2 are the most virulent among the hypervirulent K. pneumoniae (hvKP) [40]. In this study, of the 14 Klebsiella isolates belonging to K1 serotypes, six isolates carried carbapenem resistance genes, bla NDM-1 , bla OXA-181 and bla OXA-51 .…”

Section: Discussionmentioning

confidence: 80%

Molecular characterization and replicon typing of plasmids encoding carbapenemases in Gram-negative bacteria

Manohar

Kale

Lopes

et al. 2019

Preprint

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Background Carbapenem resistance in Gram-negative bacteria is an ongoing public-health problem of global dimensions leaving very few treatment options for severely infected patients. This study focuses on the dissemination of plasmid-borne carbapenemase genes in Gram-negative bacteria in Tamil Nadu, India. A total of 151 non-repetitive isolates belonging to 11 genera were collected from a diagnostic center in Tamil Nadu. Minimal inhibitory concentration of imipenem and meropenem were determined using micro-broth dilution method. E. coli pathotyping, Klebsiella serotyping, screening for beta-lactamases and plasmid incompatibility grouping was performed.Results E. coli (n=57) isolates were classified as, Enteropathogenic (n=12), Enteroaggregative (n=9), Enterohemorrhagic (n=8), Enterotoxigenic (n=3), Enteroinvasive (n=1) and unclassified E. coli (n=24). Of the 45 Klebsiella species, 14 were K1 whereas 11 were K2 serotype and in 20 Klebsiella serotype could not be determined. Other isolates (n=49) consisted of P. aeruginosa , S. typhi , E. cloacae , A. baumannii , S. marcescens , A. xylosoxidans , P. mirabilis and E. meningoseptica . Of the total number of isolates, 71% (n=107) and 68% (n=103) were found to be resistant to meropenem and imipenem respectively. The most prevalent beta-lactamase gene was bla NDM-1 (21%, 12/57) followed by bla OXA-181 (16%, 9/57) both detected in E. coli . Other carbapenemase genes detected were bla GES-9 (n=8), bla OXA-23 (n=7) and bla IMP-1 (n=3). Interestingly bla GES-1 (n=11), bla OXA-51 (n=9) were also detected. The unusual presence of bla OXA-23 was seen in E. coli (n=4), and bla OXA-23 and bla OXA-51 (IncA/C) in K. pneumoniae (n=3). Plasmid incompatibility (inc/rep) typing results showed that the plasmids carrying resistance genes (n=11) belonged to IncX, IncA/C, IncFIA-FIB and IncFIIA groups. Six E. coli isolates and one K. pneumoniae were able to transfer plasmid-borne carbapenemase ( bla NDM-1 , bla OXA-181 , bla GES-1 , bla GES-9 ) via conjugation.Conclusions This study highlights the prevalence of carbapenem resistance and the acquisition of plasmid-borne carbapenemase genes in unusual Gram-negative bacteria highlighting the role of evolution by generating microbial diversity.

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Occurrence and characterization of hyperviscous K1 and K2 serotype in Klebsiella pneumoniael

Cited by 38 publications

References 22 publications

Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives

Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives

Klebsiella pneumoniae-induced multiple invasive abscesses

Molecular characterization and replicon typing of plasmids encoding carbapenemases in Gram-negative bacteria

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