Worldwide emergence of colistin resistance in Klebsiella pneumoniae from healthy humans and patients in Lao PDR, Thailand, Israel, Nigeria and France owing to inactivation of the PhoP/PhoQ regulator mgrB: an epidemiological and molecular study

Olaitan, Abiola Olumuyiwa; Diène, Seydina M.; Kempf, Marie; Berrazeg, Meryem; Bakour, Sofiane; Gupta, Sushim K.; Thongmalayvong, Boupha; Akkhavong, Kongsap; Somphavong, Silaphet; Paboriboune, Phimpha; Chaisiri, Kittipong; Komalamisra, Chalit; Adelowo, Olawale Olufemi; Fagade, O. E.; Banjo, Omowunmi Abosede; Oke, Adeyeye James; Adler, Amos; Assous, Marc V.; Morand, Serge; Raoult, Didier; Rolain, Jean‐Marc

doi:10.1016/j.ijantimicag.2014.07.020

Cited by 230 publications

(158 citation statements)

References 29 publications

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“…In the previous study by Poudyal et al, conducted on 22 multi-drug resistant Klebsiella pneumoniae, of which 6 isolates were colistin resistant with MIC of ≥ 32 µg/mL (20). Another study in Asia, on the emergence of colistin-resistant Klebsiella pneumoniae, reveals that the prevalence rate in Lao PDR and Thailand was 5.8% and 6.6%, respectively (21). In France 2.4% and 0.7% in Nigeria were reported with MICs ranged from 3 mg/L to 64 mg/L (21).…”

Section: Discussionmentioning

confidence: 98%

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Colistin-Resistant Klebsiella pneumoniae: Prevalence of Integrons and Synergistic Out Turn for Colistin-Meropenem

Manohar

Shanthini

Pandey

et al. 2018

Arch Clin Infect Dis

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Background: Klebsiella pneumoniae has the potential to disseminate at speed among the hospital environment, hence included as a major nosocomial pathogen causes of severe infections. This work mainly focused on finding out the prevalence of different classed of integrons in colistin-resistant Klebsiellapneumoniae and to analyze the efficacy of colistin-meropenem in combination. Methods: For this cross-sectional study, random non-biased sampling technique was followed and non-repetitive, Kleb-

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Section: Discussionmentioning

confidence: 98%

“…Another study in Asia, on the emergence of colistin-resistant Klebsiella pneumoniae, reveals that the prevalence rate in Lao PDR and Thailand was 5.8% and 6.6%, respectively (21). In France 2.4% and 0.7% in Nigeria were reported with MICs ranged from 3 mg/L to 64 mg/L (21).…”

Section: Discussionmentioning

confidence: 99%

Colistin-Resistant Klebsiella pneumoniae: Prevalence of Integrons and Synergistic Out Turn for Colistin-Meropenem

Manohar

Shanthini

Pandey

et al. 2018

Arch Clin Infect Dis

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“…Several mutations in the phoP and phoQ genes are responsible for acquired resistance to polymyxins in K. pneumoniae (81,105,117,118,120,128) (Table 3). One mutation potentially involved in colistin resistance in E. coli has also been described (65).…”

Section: Fig 3 Regulation Pathways Of Lps Modifications In Klebsiellamentioning

confidence: 99%

“…Other alterations, such as insertions or deletions of small nucleotide sequences in the mgrB gene, or even some complete deletions of the mgrB locus, have been reported (120,130,131). Insertional inactivation caused by diverse insertion sequences (IS), belonging to several families and inserted at different locations within the mgrB gene, is often responsible for acquired resistance to colistin in K. pneumoniae (105,117,120,(130)(131)(132) and Klebsiella oxytoca (133,134).…”

Section: Regulators Of the Pmrab And Phopq Two-component Systemsmentioning

confidence: 99%

“…A very low colistin resistance rate was reported among K. pneumoniae isolates in Tunisia (1.2%), but this rate was probably underestimated because susceptibility to colistin was primarily screened using a DD method generating high false susceptibility rates (205). The emergence of colistin resistance was reported for K. pneumoniae isolates recovered in South Africa (81,119) and Nigeria (120).…”

Section: Poirel Et Al Clinical Microbiology Reviewsmentioning

confidence: 99%

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Polymyxins: Antibacterial Activity, Susceptibility Testing, and Resistance Mechanisms Encoded by Plasmids or Chromosomes

2017

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SUMMARY Polymyxins are well-established antibiotics that have recently regained significant interest as a consequence of the increasing incidence of infections due to multidrug-resistant Gram-negative bacteria. Colistin and polymyxin B are being seriously reconsidered as last-resort antibiotics in many areas where multidrug resistance is observed in clinical medicine. In parallel, the heavy use of polymyxins in veterinary medicine is currently being reconsidered due to increased reports of polymyxin-resistant bacteria. Susceptibility testing is challenging with polymyxins, and currently available techniques are presented here. Genotypic and phenotypic methods that provide relevant information for diagnostic laboratories are presented. This review also presents recent works in relation to recently identified mechanisms of polymyxin resistance, including chromosomally encoded resistance traits as well as the recently identified plasmid-encoded polymyxin resistance determinant MCR-1. Epidemiological features summarizing the current knowledge in that field are presented.

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Prevalence of insertion sequence elements in plasmids relating to mgrB gene disruption causing colistin resistance in Klebsiella pneumoniae

2022

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Colistin is a last resort antibiotic for the treatment of carbapenemase producing Klebsiella pneumoniae. The disruption of the mgrB gene by insertion sequences (ISs) is a mechanism mediating colistin resistance. Plasmids encode mobilizable IS elements which integrate into the mgrB gene in K. pneumoniae causing gene inactivation and colistin resistance. The species prevalence of mgrB-gene disrupting insertion elements ISL3 (ISKpn25), IS5 (ISKpn26), ISKpn14, and IS903B present on plasmids were assessed. IS containing plasmids were also scanned for antimicrobial resistance genes, including carbapenem resistant genes.Plasmids encoding ISs are abundant in K. pneumoniae. IS903B was found in 28 unique Inc groups, while ISKpn25 was largely carried by IncFIB(pQil) plasmids.ISKpn26 and ISKpn14 were most often found associated with IncFII(pHN7A8) plasmids. Of the 34 unique countries which contained any of the IS elements, ISKpn25 was identified from 26. ISKpn26, ISKpn14, and IS903B ISs were identified from 89.3%, 44.9%, and 23.9% plasmid samples from China. Plasmids carrying ISKpn25, ISKpn14, and ISKpn26 IS have a 4.6-, 6.0-, and 6.6-fold higher carbapenemase gene count, respectively, relative to IS903B-carrying plasmids. IS903B bearing plasmids have a 20-, 5-, and 5-fold higher environmental source isolation count relative to ISKpn25, ISKpn14, and ISKpn26 bearing plasmids. ISKpn25 present on IncFIB(pQil) sourced from clinical settings is established across multiple countries, while ISKpn26, ISKpn14, and IS903B appear most often in China. Carbapenemase presence in tandem with IS elements may help promote an extensively drug resistant profile in K. pneumoniae limiting already narrow treatment options.

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Worldwide emergence of colistin resistance in Klebsiella pneumoniae from healthy humans and patients in Lao PDR, Thailand, Israel, Nigeria and France owing to inactivation of the PhoP/PhoQ regulator mgrB: an epidemiological and molecular study

Cited by 230 publications

References 29 publications

Colistin-Resistant Klebsiella pneumoniae: Prevalence of Integrons and Synergistic Out Turn for Colistin-Meropenem

Colistin-Resistant Klebsiella pneumoniae: Prevalence of Integrons and Synergistic Out Turn for Colistin-Meropenem

Polymyxins: Antibacterial Activity, Susceptibility Testing, and Resistance Mechanisms Encoded by Plasmids or Chromosomes

Prevalence of insertion sequence elements in plasmids relating to mgrB gene disruption causing colistin resistance in Klebsiella pneumoniae

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