Spread of Carbapenem and Colistin-Resistant <i>Klebsiella pneumoniae</i> ST512 Clinical Isolates in Israel: A Cause for Vigilance

Lalaoui, Rym; Bakour, Sofiane; Kashat, Livnat; Assous, Marc V.; Diène, Seydina M.; Rolain, Jean‐Marc

doi:10.1089/mdr.2018.0014

Cited by 24 publications

(17 citation statements)

References 31 publications

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“…More recently, KPC-2–producing K. pneumoniae ST16 was detected in another teaching hospital also located in São Paulo [ 32 ]. This study thus depicts the largest outbreak caused by KPC-ST16 [ 16 , 17 , 33 ], which is a poorly characterized clone, in contrast to the successful ST11, ST258, ST307, or ST15 clones (also found in this study) [ 9 , 12 , 34–37 ].…”

Section: Discussionmentioning

confidence: 62%

An Emerging Clone, Klebsiellapneumoniae Carbapenemase 2–Producing K. pneumoniae Sequence Type 16, Associated With High Mortality Rates in a CC258-Endemic Setting

Andrey

Dantas

Martins

et al. 2019

Clinical Infectious Diseases

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Background Carbapenemase-producing K. pneumoniae have become a global priority, not least in low-middle income countries. Here, we report the emergence and clinical impact of a novel KPC-K. pneumoniae ST16 clone in a Clonal Complex (CC)258 endemic setting. Methods In a teaching Brazilian hospital, a retrospective cohort of adult KPC-KP bloodstream infections (BSI) cases (January 2014 to December 2016) was established to study the molecular epidemiology and its impact on outcome (30-day all-cause mortality). KPC-KP isolates were MLST-typed. Survival analysis between ST/CC groups and risk factors for fatal outcome (logistic regression) were evaluated. Representative isolates underwent whole genome sequencing (WGS), and had their virulence tested in a Galleria larvae model. Results One hundred sixty-five unique KPC-KP BSI cases were identified. CC258 was predominant (66%), followed by ST16 (12%). The overall 30-day mortality rate was 60%; in contrast, 95% of ST16 cases were fatal. Patient’s severity scores were high and baseline clinical variables were not statistically different across ST’s. In multivariate analysis, ST16 (OR 21.4; CI95% 2.3-202.8; p=0,008) and septic shock (OR 11.9; CI95% 4.2-34.1; p<0,001) were independent risk factors for fatal outcome. ST16 clone carried up to 14 resistance genes, including blaKPC-2 in an IncFIBpQIL plasmid, KL51 capsule and Yersiniabactin virulence determinants. ST16 clone was highly pathogenic in the larvae model. Conclusions Mortality rates were high in this KPC-KP BSI cohort, where CC258 is endemic. An emerging ST16 clone was associated with high mortality. Our results suggest that even in endemic settings, highly virulent clones can rapidly emerge demanding constant monitoring.

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Section: Discussionmentioning

confidence: 62%

An Emerging Clone, Klebsiellapneumoniae Carbapenemase 2–Producing K. pneumoniae Sequence Type 16, Associated With High Mortality Rates in a CC258-Endemic Setting

Andrey

Dantas

Martins

et al. 2019

Clinical Infectious Diseases

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“…Susceptibility testing showed clear endpoints with a 100% growth inhibition of the MDR strains tested. The MICs of Escherichia coli LH1 (MIC = 8 μg/ml) (16), Escherichia coli 1R4 (MIC = 8 μg/ml) (17) and Klebsiella pneumoniae 853 (MIC = 64 μg/ml) [20] were within the quality control ranges.…”

Section: Resultsmentioning

confidence: 99%

“…These strains were isolated from different clinical samples including blood culture, cerebrospinal fluid, nails, bronchial aspiration and ocular samples (Table 1). Candida krusei ATCC 6258, Candida parapsilosis ATCC 22019, Aspergillus fumigatus ATCC 204205, Aspergillus flavus ATCC 204304, Escherichia coli LH1 [18], Escherichia coli 1R4 [19] and Klebsiella pneumoniae 853 [20] were used as susceptibility testing quality controls.…”

Section: Methodsmentioning

confidence: 99%

In vitro polymyxin activity against clinical multidrug-resistant fungi

Yousfi

Ranque

Rolain

et al. 2019

Antimicrob Resist Infect Control

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Background Although antifungals are available and usually used against fungal infections, multidrug-resistant (MDR) fungal pathogens are a growing problem for public health. Moreover, fungal infections have become more prevalent nowadays due to the increasing number of people living with immunodeficiency. Thus, previously rarely-isolated and/or unidentified fungal species including MDR yeast and moulds have emerged around the world. Recent works indicate that polymyxin antibiotics (polymyxin B and colistin) have potential antifungal proprieties. Therefore, investigating the in vitro activity of these molecules against clinical multidrug-resistant yeast and moulds could be very useful. Methods In this study, a total of 11 MDR yeast and filamentous fungal strains commonly reported in clinical settings were tested against polymyxin antibiotics. These include strains belonging to the Candida , Cryptococcus and Rhodotorula yeast genera, along with others belonging to the Aspergillus , Fusarium , Scedosporium , Lichtheimia and Rhizopus mould genera. The fungicidal or fungistatic action of colistin against clinical yeast strains was determined by the time-kill study. Further, a checkerboard assay for its combination with antifungal agents, usually used in clinical practices (amphotericin B, itraconazole, voriconazole), was carried out against multi-drug resistant fungal strains. Results Polymyxin B and colistin exhibited an antifungal activity against all MDR fungal strains tested with MICs ranging from 16 to 128 μg/ml, except for the Aspergillus species. In addition, colistin has a fungicidal action against yeast species, with minimum fungicidal concentrations ranging from 2 to 4 times MICs. It induces damage to the MDR Candida albicans membrane. A synergistic activity of colistin-amphotericin B and colistin-itraconazole associations against Candida albicans and Lichtheimia corymbifera strains, respectively, and colistin-fluconazole association against Rhodotorula mucilaginosa, was demonstrated using a checkerboard microdilution assay. Conclusion colistin could be proposed, in clinical practice, in association with other antifungals, to treat life-threatening fungal infections caused by MDR yeasts or moulds.

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“…The third-generation cephalosporin- and carbapenem-resistant isolates were screened for the presence of genes encoding ESBLs ( bla CTX-M , bla TEM , bla SHV ) and carbapenemases ( bla OXA-48 , bla VIM , bla IMP , bla NDM and bla KPC ), using the quantitative real-time PCR (qPCR) as previously described [ 26 ]. The qPCR positive isolates were confirmed by conventional PCR.…”

Section: Methodsmentioning

confidence: 99%

Phenotypic and genotypic characterization of clinical carbapenem-resistant Enterobacteriaceae isolates from Sokoto, northwest Nigeria

Olowo-Okere

Ibrahim

Olayinka

et al. 2020

New Microbes and New Infections

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Emergence and spread of carbapenemase-producing Enterobacteriaceae (CPE) are two of the major problems currently threatening global public health. In Nigeria, interest in CPE is recent. In Sokoto, northwest Nigeria, there are no data on the prevalence and mechanism underlying carbapenem resistance. In this study, we aimed to investigate the presence of clinical carbapenems-resistant Enterobacteriaceae isolates in two leading hospitals in Sokoto, northwest Nigeria. A total of 292 non-duplicate Enterobacteriaceae isolated from clinical specimens processed in the diagnostic laboratories of two hospitals between January and June 2019 were collected. Of these, 129 (44.2 %) and 19 (6.5%) were resistant to third-generation cephalosporin and carbapenems, respectively. RT-PCR revealed that 10 (7.8%), 19 (14.7%) and 46 (35.7%) of the third-generation cephalosporin-resistant isolates harboured bla SHV , bla TEM and bla CTX-M genes, respectively. The modified Carba NP test result showed that only 7 (36.8 %) of the 19 carbapenem-resistant isolates were carbapenemase producing; among them, bla NDM-5 and bla OXA-181 genes were identified in five and two isolates, respectively. However, none of the carbapenemase genes investigated, including bla VIM , bla KPC and bla IMP , was detected in the remaining carbapenem-resistant isolates, suggesting a non-enzymatic mechanism. This study reports for the first time, the emergence of CPE in Sokoto state and the detection of NDM-producing Citrobacter freundii in Nigeria. The observed CPE in this study is a concern in a country where alternative antibiotics are rarely available.

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Spread of Carbapenem and Colistin-Resistant Klebsiella pneumoniae ST512 Clinical Isolates in Israel: A Cause for Vigilance

Abstract: In this study, we report the usefulness of whole-genome sequencing in detection of antibiotic resistance mechanisms and in highlighting the emergence of the carbapenem and colistin-resistant K. pneumoniae clone ST512 in Israeli hospitals.

Cited by 24 publications

References 31 publications

An Emerging Clone, Klebsiellapneumoniae Carbapenemase 2–Producing K. pneumoniae Sequence Type 16, Associated With High Mortality Rates in a CC258-Endemic Setting

An Emerging Clone, Klebsiellapneumoniae Carbapenemase 2–Producing K. pneumoniae Sequence Type 16, Associated With High Mortality Rates in a CC258-Endemic Setting

In vitro polymyxin activity against clinical multidrug-resistant fungi

Phenotypic and genotypic characterization of clinical carbapenem-resistant Enterobacteriaceae isolates from Sokoto, northwest Nigeria

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