The Diversity of Lipopolysaccharide (O) and Capsular Polysaccharide (K) Antigens of Invasive Klebsiella pneumoniae in a Multi-Country Collection

Choi, Myeongjin; Hégerlé, Nicolas; Nkeze, Joseph; Sen, Shaichi; Jamindar, Sanchita; Nasrin, Shamima; Sen, Sudipta; Permala-Booth, Jasnehta; Sinclair, James L.; Tapia, Milagritos D.; Johnson, J. Kristie; Sylla, Mamadou Alpha; Thaden, Joshua T.; Fowler, Vance G.; Aguilar, Ana Cristina; Terán, Enrique; Decré, Dominique; Morel, Florence; Krogfelt, Karen A.; Brauner, Annelie; Protonotariou, Efthimia; Christaki, Eirini; Shindo, Yuichiro; Lin, Yi Tsung; Kwa, Andrea Lay-Hoon; Shakoor, Sadia; Singh-Moodley, Ashika; Perovic, Olga; Jacobs, Jan; Lunguya, Octavie; Simon, Raphael; Cross, Alan S.; Tennant, Sharon M.

doi:10.3389/fmicb.2020.01249

Cited by 72 publications

(85 citation statements)

References 47 publications

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“…The high prevalence genes conferring resistance to fluoroquinolones and extended-spectrum βlactams, last-line options for Nigeria's least affluent patients, in the most common lineages, reported here is of concern in spite of relatively low rates of carbapenem resistance in our setting, or elsewhere in Africa, compared to other countries [15,31,32,33]. Moreover, while uncommon in this study, ST147 and ST392 strains bearing blaNDM-1, and ST101 strains carrying blaOXA-48were documented [37].…”

Section: Discussionmentioning

confidence: 77%

“…Clonal group (CG) 307 is believed to be displacing the notorious CG258 as a primary lineage in South Africa, Italy, Colombia, and the USA, and it may be more virulent [31,[36][37][38][39][40]. The high ST307 frequency here, and in Malawiand South Africa, may explain the low overall prevalence of carbapenem resistance we observed compared to other locations [14,17,32,35].…”

Section: Discussionmentioning

confidence: 83%

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Clones and Clusters of Antimicrobial-Resistant Klebsiella from Southwestern Nigeria

Afolayan

Oaikhena

Aboderin

et al. 2021

Preprint

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Introduction: Klebsiellapneumoniae is a World Health Organization high-priority antibiotic-resistant pathogen. However, little is known about the population structure and evolution of Klebsiella circulating in Nigeria. Methods: We performed whole genome sequencing (WGS) of 141 Klebsiella isolated between 2016 and 2018 from clinical specimens at 3 antimicrobial-resistance (AMR) sentinel surveillance tertiary hospitals in southwestern Nigeria. We conducted insilico multilocus sequence typing, AMR gene, virulence gene, plasmid, and K and O loci profiling, as well as phylogenetic analyses, using publicly available tools and Nextflow pipelines. Results: Phylogenetic analysis revealed that the majority of the 134 K. pneumoniae and 5 K. quasipneumoniae isolates from Nigeria characterized are closely related to globally disseminated multidrug-resistant clones. Of the 39 K. pneumoniae sequence types (STs) identified, the most common were ST307 (15%), ST5241 (12%), ST15 (≈9%), and ST25 (≈6%). ST5241, one of 10 novel STs detected, is a single locus variant of ST636 carrying dfrA14, tetD, qnrS, and oqxAB resistance genes. The extended-spectrum β lactamase (ESBL) gene blaCTX_M-15 was seen in 72 % of K. pneumoniae genomes, while 8% encoded a carbapenemase. Four likely outbreak clusters from one facility, within STs 17, 25, 307, and 5241, were ESBL but not carbapenemase-bearing clones. Conclusion: This study uncovered known and novel K. pneumoniae lineages circulating in Nigeria that include multidrug-resistant ESBL producers. Carbapenemase-producing isolates remain uncommon. WGS retrospectively identified outbreak clusters, pointing to the value of genomic approaches in AMR surveillance for improving infection prevention and control in Nigerian hospitals.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 83%

Clones and Clusters of Antimicrobial-Resistant Klebsiella from Southwestern Nigeria

Afolayan

Oaikhena

Aboderin

et al. 2021

Preprint

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“…Bacteria also produce polysaccharide capsules for their protection, which are one of the most important virulence factors in pathogens 38 . Bacterial virulence genes/factors enable them to bypass the hosts' defence systems 84 . MGEs, RMSs, virulence genes and capsules all contribute to AMR in GNB.…”

Section: Discussionmentioning

confidence: 99%

Phylogenomics, Epigenomics, Virulome, and Mobilome of Gram-negative Bacteria Co-resistant to Carbapenems and Polymyxins: A One-Health Systematic Review and Meta-analyses

2021

Preprint

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Gram-negative bacteria (GNB) continue to develop resistance against important antibiotics including last-resort ones such as carbapenems and polymyxins. An analysis of GNB with co-resistance to carbapenems and polymyxins from a One Health perspective is presented. Data of species name, country, source of isolation, resistance genes (ARGs), plasmid type, clones, and mobile genetic elements (MGEs) were deduced from 129 articles from January 2016 to March 2021. Available genomes and plasmids were obtained from PATRIC and NCBI. Resistomes and methylomes were analysed using BAcWGSTdb and REBASE whilst Kaptive was used to predict capsule typing. Plasmids and other MEGs were identified using MGE Finder and ResFinder. Phylogenetic analyses were done using RAxML and annotated with MEGA 7. A total of 877 isolates, 32 genomes and 44 plasmid sequences were analysed. Most of these isolates were reported in Asian countries and were isolated from clinical, animal, and environmental sources. Colistin resistance was mostly mediated by mgrB inactivation, while OXA-48/181 was the most reported carbapenemase. IncX and IncI were the most common plasmids hosting carbapenemases and mcr genes. The isolates were co-resistant to other antibiotics, with floR (chloramphenicol) and fosA3 (fosfomycin) being common; E. coli ST156 and K. pneumoniae ST258 strains were common globally. Virulence genes and capsular KL-types were also detected. Type I, II, III and IV restriction modification systems were detected, comprising various MTases and restriction enzymes. The escalation of highly resistant isolates drains the economy due to untreatable bacterial infections, which leads to increasing global mortality rates and healthcare costs.

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“…In contrast, Kp has a surprisingly low number of reported O-antigens and only 11 distinct serotypes have been described. O1, O2, O3 and O5 are most commonly found in Kp clinical isolates, despite the fact that the prevalence of each serotype can vary based on the geographical regions and the MDR or Hv phenotypes [ 54 , 57 , 58 ].…”

Section: Klebsiella Pneumoniae Diversitymentioning

confidence: 99%

Prophylaxis and Treatment against Klebsiella pneumoniae: Current Insights on This Emerging Anti-Microbial Resistant Global Threat

Arato

Raso

Gasperini

et al. 2021

IJMS

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Klebsiella pneumoniae (Kp) is an opportunistic pathogen and the leading cause of healthcare-associated infections, mostly affecting subjects with compromised immune systems or suffering from concurrent bacterial infections. However, the dramatic increase in hypervirulent strains and the emergence of new multidrug-resistant clones resulted in Kp occurrence among previously healthy people and in increased morbidity and mortality, including neonatal sepsis and death across low- and middle-income countries. As a consequence, carbapenem-resistant and extended spectrum β-lactamase-producing Kp have been prioritized as a critical anti-microbial resistance threat by the World Health Organization and this has renewed the interest of the scientific community in developing a vaccine as well as treatments alternative to the now ineffective antibiotics. Capsule polysaccharide is the most important virulence factor of Kp and plays major roles in the pathogenesis but its high variability (more than 100 different types have been reported) makes the identification of a universal treatment or prevention strategy very challenging. However, less variable virulence factors such as the O-Antigen, outer membrane proteins as fimbriae and siderophores might also be key players in the fight against Kp infections. Here, we review elements of the current status of the epidemiology and the molecular pathogenesis of Kp and explore specific bacterial antigens as potential targets for both prophylactic and therapeutic solutions.

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The Diversity of Lipopolysaccharide (O) and Capsular Polysaccharide (K) Antigens of Invasive Klebsiella pneumoniae in a Multi-Country Collection

Cited by 72 publications

References 47 publications

Clones and Clusters of Antimicrobial-Resistant Klebsiella from Southwestern Nigeria

Clones and Clusters of Antimicrobial-Resistant Klebsiella from Southwestern Nigeria

Phylogenomics, Epigenomics, Virulome, and Mobilome of Gram-negative Bacteria Co-resistant to Carbapenems and Polymyxins: A One-Health Systematic Review and Meta-analyses

Prophylaxis and Treatment against Klebsiella pneumoniae: Current Insights on This Emerging Anti-Microbial Resistant Global Threat

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