Prevalence of hypervirulent Klebsiella pneumoniae-associated genes rmpA and magA in two tertiary hospitals in Houston, TX, USA

Chou, Andrew; Nuila, Ricardo; Franco, Luis M.; Stager, Charles E.; Atmar, Robert L.; Zechiedrich, Lynn

doi:10.1099/jmm.0.000309

Cited by 25 publications

(28 citation statements)

References 19 publications

(19 reference statements)

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“… 38 In the USA, 6.3% of the 64 isolates obtained from blood cultures were found to be rmpA - or magA -positive. 39 These reports indicate that the prevalence of specific serotypes and the hypermucoviscous phenotype vary geographically.…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological characteristics and occurrence of <em>Klebsiella pneumoniae</em> infection in Japan

Ikeda¹,

Mizoguchi²,

Oshida³

et al. 2018

IJGM

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PurposeKlebsiella pneumoniae is a pathogen that causes pneumonia and urinary tract infection. Hypervirulent K. pneumoniae strains often show hypermucoviscosity, are of the K1 or K2 serotype, and harbor the rmpA and magA genes. However, the differences in the prevalence of K. pneumoniae with these hypervirulent characteristics between the infection and colonization status are not well understood. Therefore, in this study, we compared the clinical and microbiological characteristics of K. pneumoniae isolated from urine or sputum samples of cases of infection and colonization.Patients and methodsThis retrospective study was conducted at a tertiary care teaching hospital in Tokyo, Japan. Patients whose sputum or urine tested positive for the presence of K. pneumoniae isolates were randomly included in the study. Clinical and microbiological data were collected from medical records.ResultsOf the 130 cases investigated, 68 and 62 cases showed the presence of K. pneumoniae in the sputum and urine, respectively. There were 49 infection cases, including 21 in the sputum group and 28 in the urine group. The infections were not accompanied by liver abscess. Of the 130 K. pneumoniae isolates, 25 (19.2%) showed capsular serotype K1 or K2, whereas 33 (25.4%) showed hypermucoviscosity. The prevalence of virulence genes magA, allS, rmpA, mrkD, uge, kfu-BC, and wabG was 10% (all in K1), 13.1%, 16.9%, 85.4%, 79.2%, 36.9%, and 91.5%, respectively. In both the sputum and urine groups, there was no difference in the characteristics of patients with infection and those with colonization. Analysis of microbiological characteristics revealed that only rmpA was significantly more frequent in the infection cases than in the colonization/asymptomatic cases in both the sputum and urine groups.ConclusionThe rmpA-positive K. pneumoniae isolates were dominant in the infection cases compared with those in the colonization/asymptomatic cases, suggesting that rmpA may play a crucial role in the development of urinary tract infection and pneumonia.

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Section: Discussionmentioning

confidence: 99%

Clinical and microbiological characteristics and occurrence of <em>Klebsiella pneumoniae</em> infection in Japan

Ikeda¹,

Mizoguchi²,

Oshida³

et al. 2018

IJGM

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“…Based on being positive for either iucA, or iroB gene, a total of 65 K. pneumoniae isolated from 65 patients with hospital-acquired infections in the ICUs of Mansoura University Hospital in Egypt were subjected to hvKp identification, of which only four strains were identified as probable hvKp [19]. With magA and rmpA genes being amplified by end point PCR, only three (7.9 %) out of 38 K. pneumoniae isolates carried one or both hvKp-associated genes in Houston, TX, USA [20]. Of 31 blood cultured K. pneumoniae isolates, 4 isolates were identified as hvKp by hypermucoviscous phenotype and magA/rmpA genotypes in South Australian hospitals [21].…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological characteristics of hypervirulent Klebsiella pneumoniae (hvKp) in a hospital from North China

Yang

Liu

et al. 2020

J Infect Dev Ctries

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Introduction: The clinical and molecular characteristics of hypervirulent Klebsiella pneumoniae (hvKp) in various provinces of China have been reported, however, there have been few reports in Hebei Province, North China. Methodology: The hvKp was identified by PCR amplification of hypervirulence-related genes, the hypermucoviscous phenotype was determined by the "string test", the drug susceptibility analysis was performed using the VITEK® 2 Compact Bacterial Identification and Monitoring System. Logistic regression was used to identify risk factors for hvKp infection. The molecular epidemiological characteristics of the strains were analyzed by pulsed-field gel electrophoresis (PFGE), and the capsular serotype of hvKp strain was detected by PCR. Results: Overall, 52.21% (59/113) of K. pneumoniae isolates were hvKp, and the ratios of patients with older ages or a higher PMN cell count among hvKp infection were higher than those among classical Klebsiella pneumoniae (cKp) infection. hvKp are more susceptible to antibacterial drugs than cKp, and one ESBLs-producing hvKp strain was detected. The main capsular serotype of hvKp were K2, K57 and K1. PFGE indicated that the 59 strains of hvKp could be classified into 51 PFGE band types, forming 6 PFGE clusters. Conclusions: In this study, the detection rate of hvKp was 52.21% (59/113) identified by virulence genes. People with older ages or a higher PMN cell count are more likely to gain hvKp infection. ESBLs-producing hvKp is emerging, indicating the importance of epidemiologic surveillance and clinical awareness of this pathogen in this region.

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“…Case reports indicate that hvKp strains exist in the U.S., but their prevalence is unclear and has only been investigated in two surveillance studies (24,25). In this work, we determined the prevalence of hvKp at NMH by identifying isolates using diagnostic criteria of hvKp.…”

Section: Discussionmentioning

confidence: 99%

“…Kp strains were analyzed from two hospitals in the greater Houston area (25). They identified four strains (6.25%) containing hvKp pathogenicity-associated genes, based on the presence of rmpA and K1 capsule type by PCR amplification.…”

Section: Discussionmentioning

confidence: 99%

“…CC-BY-NC-ND 4.0 International license available under a (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made common in Asia, but little is known about their prevalence in the U.S. Case reports document the presence of hvKp infections and PLA in North America, but only a few surveillance studies have been performed (21,(24)(25)(26). hvKp strains frequently express a highly mucoid capsule, leading to a "hypermucoviscous" colony phenotype, and are considerably more virulent in mouse models than cKp strains (23).…”

Section: Introductionmentioning

confidence: 99%

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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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Prevalence of hypervirulent Klebsiella pneumoniae-associated genes rmpA and magA in two tertiary hospitals in Houston, TX, USA

Cited by 25 publications

References 19 publications

Clinical and microbiological characteristics and occurrence of <em>Klebsiella pneumoniae</em> infection in Japan

Clinical and microbiological characteristics and occurrence of <em>Klebsiella pneumoniae</em> infection in Japan

Clinical and microbiological characteristics of hypervirulent Klebsiella pneumoniae (hvKp) in a hospital from North China

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

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