scholarly journals First report of New Clonal groups ST706 and ST1088 from MDR Klebsiella pneumoniae Mexican strains

2019 ◽  
Author(s):  
María Guadalupe Córdova-Espinoza ◽  
Eder Daniel Hernández Arana ◽  
Silvia Giono-Cerezo ◽  
Erika Gabriela Sierra Atanacio ◽  
Eduardo Carrillo Tapia ◽  
...  
Keyword(s):  
Population Structure ◽  
Klebsiella Pneumoniae ◽  
Clonal Complex ◽  
Multidrug Resistant ◽  
Blood Cultures ◽  
Hospital Environment ◽  
Automated System ◽  
Resistant Phenotype ◽  
Microbiological Methods ◽  
Mexican Strains

AbstractMultidrug-resistant Klebsiella pneumoniae Mexican strains were characterized for the identification of endemic and pandemic clonal groups. The aims of this study were to know population structure and to identify endemic clonal groups inside K. pneumoniae Mexican strains isolated from clinical sources. We studied 93 isolated strains from three third level hospitals and one family clinic from Mexico City. Identification of the strains was done by conventional microbiological methods and an automated system (Vitek2®). The multidrug-resistant phenotype was confirmed following CLSI recommendations, and the strains were classified as MDR, XDR and PDR. Molecular characterization was done by Multilocus Sequence Typing scheme (rpoB, gapA, mdh, pgi, phoE, infB, y tonB). All strains were isolated from hospitalized patients, the most frequent sources were urine and blood cultures. Population structure of K. pneumoniae was clonal, 30 ST were identified, six of them are commonly found. The Clonal complex ST25, ST36, S5392, ST405 and ST551 were isolated from clinical sources, ST1088 was isolated from surfaces of hospital environment.

scholarly journals Clonal Dissemination of KPC-2, VIM-1, OXA-48-Producing Klebsiella pneumoniae ST147 in Katowice, Poland

2021 ◽  
Vol 70 (1) ◽  
pp. 107-116
Author(s):  
DOROTA OCHOŃSKA ◽  
HANNA KLAMIŃSKA-CEBULA ◽  
ANNA DOBRUT ◽  
MAŁGORZATA BULANDA ◽  
MONIKA BRZYCHCZY-WŁOCH
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Test Method ◽  
Hospital Environment ◽  
Single Strain ◽  
Minimal Inhibitory Concentrations ◽  
Carbapenem Resistant ◽  
Resistant Phenotype ◽  
Drug Resistant Phenotype ◽  
Synergy Test

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an important bacterium of nosocomial infections. In this study, CRKP strains, which were mainly isolated from fecal samples of 14 patients in three wards of the hospital in the Silesia Voivodship, rapidly increased from February to August 2018. Therefore, we conducted microbiological and molecular studies of the CRKP isolates analyzed. Colonized patients had critical underlying diseases and comorbidities; one developed bloodstream infection, and five died (33.3%). Antibiotic susceptibilities were determined by the E-test method. A disc synergy test confirmed carbapenemase production. CTX-Mplex PCR evaluated the presence of resistance genes blaCTX-M-type, blaCTX-M-1, blaCTX-M-9, and the genes blaSHV, blaTEM, blaKPC-2, blaNDM-1, blaOXA-48, blaIMP, and blaVIM-1 was detected with the PCR method. Clonality was evaluated by Multi Locus Sequence Typing (MLST) and Pulsed Field Gel Electrophoresis (PFGE). Six (40%) strains were of XDR (Extensively Drug-Resistant) phenotype, and nine (60%) of the isolates exhibited MDR (Multidrug-Resistant) phenotype. The range of carbapenem minimal inhibitory concentrations (MICs, μg/mL) was as follows doripenem (16 to > 32), ertapenem (> 32), imipenem (4 to > 32), and meropenem (> 32). PCR and sequencing confirmed the blaCTX-M-15, blaKPC-2, blaOXA-48, and blaVIM-1 genes in all strains. The isolates formed one large PFGE cluster (clone A). MLST assigned them to the emerging high-risk clone of ST147 (CC147) pandemic lineage harboring the blaOXA-48 gene. This study showed that the K. pneumoniae isolates detected in the multi-profile medical centre in Katowice represented a single strain of the microorganism spreading in the hospital environment.

scholarly journals Characterization of Multidrug-resistant and Virulent Klebsiella Pneumoniae Strains Belonging to the High-risk CG258 Isolated from Inpatients in Northeastern Brazil

2021 ◽  
Author(s):  
Rafael Nakamura-Silva ◽  
Mariana Oliveira-Silva ◽  
João Pedro Rueda Furlan ◽  
Eliana Guedes Stehling ◽  
Carlos Eduardo Saraiva Miranda ◽  
...  
Keyword(s):  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Northeastern Brazil ◽  
Hospital Environment ◽  
Global Public Health ◽  
Antimicrobial Resistance Profile ◽  
First Time

Abstract Multidrug-resistant (MDR) and hypervirulent Klebsiella pneumoniae (hvKp) clones have become a major threat to global public health. The CG258 is considered a high-risk CG and the K. pneumoniae strains belonging to it are known to be often multi-resistant and to spread mainly in the hospital environment. This study aimed to characterize the antimicrobial resistance profile, virulence factors, and the clonal relationships among 13 K. pneumoniae strains belonging to CG258 from patients admitted to a tertiary hospital in Teresina, in the state of Piauí, northeastern Brazil. Ten strains were classified as MDR and three as extensively drug-resistant (XDR). Three different β-lactamase-encoding genes ( bla KPC , bla OXA-1- like , and bla CTX-M-Gp1) and six virulence genes ( fimH , ycfM , mrkD , entB , ybtS , and kfu ) were detected. Moreover, two hypermucoviscous K. pneumoniae strains and one capsular K-type 2 were found. Multilocus sequence typing analysis revealed 10 different sequence types (STs) (ST14, ST17, ST20, ST29, ST45, ST101, ST268, ST1800, ST3995, and ST3996) belonging to CG258, being two (ST3995 and ST3996) described for the first time in this study.

scholarly journals Draft Genome Sequence of a Hospital-Associated Clone of Klebsiella pneumoniae ST340/CC258 Coproducing RmtG and KPC-2 Isolated from a Pediatric Patient

2016 ◽  
Vol 4 (6) ◽  
Author(s):  
Louise Cerdeira ◽  
Miriam R. Fernandes ◽  
Gabriela R. Francisco ◽  
Maria Fernanda C. Bueno ◽  
Susan Ienne ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Pediatric Patient ◽  
Genome Sequence ◽  
Clonal Complex ◽  
Draft Genome ◽  
Multidrug Resistant ◽  
Sequence Type ◽  
Draft Genome Sequence ◽  
Catheter Tip ◽  
Multidrug Resistant Strain

We report here the draft genome sequence of a Klebsiella pneumoniae strain 1194/11, belonging to the hospital-associated sequence type 340 (ST340; clonal complex CC258), isolated from a catheter tip culture from a pediatric patient. The multidrug-resistant strain coproduced the 16S rRNA methyltransferase rRNA RmtG and β-lactamases KPC-2 and CTX-M-15.

scholarly journals mgrBMutations Mediating Polymyxin B Resistance in Klebsiella pneumoniae Isolates from Rectal Surveillance Swabs in Brazil

2016 ◽  
Vol 60 (11) ◽  
pp. 6969-6972 ◽  
Author(s):  
Caio Augusto Martins Aires ◽  
Polyana Silva Pereira ◽  
Marise Dutra Asensi ◽  
Ana Paula D'Alincourt Carvalho-Assef
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Mechanisms ◽  
Clonal Complex ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Insertion Sequences ◽  
Missense Mutations ◽  
Content Type ◽  
Rectal Swabs

ABSTRACTWe aimed to investigate polymyxin B (PMB) resistance and its molecular mechanisms in 126Klebsiella pneumoniaeisolates from rectal swabs in Brazil. Ten isolates exhibited PMB resistance with interruption ofmgrBgene by insertion sequences or missense mutations. Most of the PMB-resistant isolates harboredblaKPC-2(n= 8) and belonged to clonal complex 258 (CC258) (n= 7). These results highlight the importance of monitoring the spread of polymyxin-resistant bacteria in hospitals, since few options remain to treat multidrug-resistant isolates.

scholarly journals Mobile Plasmid Mediated Transition From Colistin-Sensitive to Resistant Phenotype in Klebsiella pneumoniae

2021 ◽  
Vol 12 ◽  
Author(s):  
Baoyue Zhang ◽  
Bing Yu ◽  
Wei Zhou ◽  
Yue Wang ◽  
Ziyong Sun ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Sequencing Analysis ◽  
Direct Repeats ◽  
Colistin Resistance ◽  
Health Crisis ◽  
Carbapenem Resistant ◽  
Resistant Phenotype ◽  
New Challenges

Multidrug-resistant bacteria, including carbapenem-resistant Klebsiella pneumoniae (CRKP), are becoming an increasing health crisis worldwide. For CRKP, colistin is regarded as “the last treatment option.” In this study, we isolated a clinical CRKP strain named as K. pneumoniae R10-341. Phenotyping analysis showed that this strain could transit from a colistin-sensitive to a resistant phenotype by inserting an IS4 family ISKpn72 element into the colistin-resistance associated mgrB gene. To investigate the mechanism of this transition, we performed genome sequencing analysis of the colistin-sensitive parental strain and found that 12 copies of ISKpn72 containing direct repeats (DR) are located on the chromosome and 1 copy without DR is located on a multidrug-resistant plasmid pR10-341_2. Both types of ISKpn72 could be inserted into the mgrB gene to cause colistin-resistance, though the plasmid-derived ISKpn72 without DR was in higher efficiency. Importantly, we demonstrated that colistin-sensitive K. pneumoniae strain transferred with the ISKpn72 element also obtained the ability to switch from colistin-sensitive to colistin-resistant phenotype. Furthermore, we confirmed that the ISKpn72-containing pR10-341_2 plasmid was able to conjugate, suggesting that the ability of causing colistin-resistant transition is transferable through common conjugation. Our results point to new challenges for both colistin-resistance detection and CRKP treatment.

scholarly journals Antibiotic resistance, virulence-associated genes analysis and molecular typing of Klebsiella pneumoniae strains recovered from clinical samples

AMB Express ◽  
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amir Mirzaie ◽  
Reza Ranjbar
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Molecular Typing ◽  
Efflux Pump ◽  
Opportunistic Pathogen ◽  
Relevant Information ◽  
Multidrug Resistant ◽  
Clinical Samples ◽  
Microbiological Methods ◽  
High Level

AbstractKlebsiella pneumoniae is a multidrug-resistant (MDR) opportunistic pathogen that causes nosocomial infections. Virulence analysis and molecular typing as powerful approaches can provide relevant information on K. pneumoniae infection. In the current study, antibiotic resistance, virulence-associated genes analysis, as well as molecular typing of K. pneumoniae strains were investigated. Out of 505 clinical samples collected from hospitalized patients, 100 K. pneumoniae strains were isolated by standard microbiological methods and subjected to the phenotypic and genotyping analysis. The highest prevalence of resistance was observed against ciprofloxacin (75%), trimethoprim–sulfamethoxazole (73%) and nitrofurantoin (68%). Virulence associated genes including entB, traT, ybts, magA, iucC, htrA and rmpA were found in 80%, 62%, 75%, 5%, 30%, 72% and 48%, of the isolates, respectively. The prevalence of biofilm-associated genes including mrkA, fimH, and mrkD were equally 88% for all tested isolates. Moreover, the efflux pump genes including AcrAB, TolC and mdtK were observed in 41 (41%), 33 (33%) and 26 (26%) of the strains respectively. A significant statistical association was observed between MDR strains and high expression of efflux pump and biofilm genes. The K. pneumoniae strains were differentiated into 11 different genetic patterns using the repetitive element sequence-based PCR (rep-PCR) technique. High prevalence of resistance, presence of various virulence factors, high level of efflux pump, and biofilm gene expression in diverse clones of K. pneumoniae strains pose an important health issue in clinical settings.

scholarly journals Community- and Hospital-Acquired Klebsiella pneumoniae Urinary Tract Infections in Portugal: Virulence and Antibiotic Resistance

2019 ◽  
Vol 7 (5) ◽  
pp. 138 ◽  
Author(s):  
Cátia Caneiras ◽  
Luis Lito ◽  
José Melo-Cristino ◽  
Aida Duarte
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Virulence Determinants ◽  
Antibiotic Resistance Profile ◽  
Tract Infections ◽  
Hospital Acquired

Klebsiella pneumoniae is a clinically relevant pathogen and a frequent cause of hospital-acquired (HA) and community-acquired (CA) urinary tract infections (UTI). The increased resistance of this pathogen is leading to limited therapeutic options. To investigate the epidemiology, virulence, and antibiotic resistance profile of K. pneumoniae in urinary tract infections, we conducted a multicenter retrospective study for a total of 81 isolates (50 CA-UTI and 31 HA-UTI) in Portugal. The detection and characterization of resistance and virulence determinants were performed by molecular methods (PCR, PCR-based replicon typing, and multilocus sequence typing (MLST)). Out of 50 CA-UTI isolates, six (12.0%) carried β-lactamase enzymes, namely blaTEM-156 (n = 2), blaTEM-24 (n = 1), blaSHV-11 (n = 1), blaSHV-33 (n = 1), and blaCTX-M-15 (n = 1). All HA-UTI were extended-spectrum β-lactamase (ESBL) producers and had a multidrug resistant profile as compared to the CA-UTI isolates, which were mainly resistant to ciprofloxacin, levofloxacin, tigecycline, and fosfomycin. In conclusion, in contrast to community-acquired isolates, there is an overlap between virulence and multidrug resistance for hospital-acquired UTI K. pneumoniae pathogens. The study is the first to report different virulence characteristics for hospital and community K. pneumoniae pathogens, despite the production of β-lactamase and even with the presence of CTX-M-15 ESBL, a successful international ST15 clone, which were identified in both settings. This highlights that a focus on genomic surveillance should remain a priority in the hospital environment.

scholarly journals Epidemiological profile of healthcare-associated infections caused by Carbapenemase-producing Enterobacteriaceae

2019 ◽  
Vol 53 ◽  
Author(s):  
André Luiz Silva Alvim ◽  
Bráulio Roberto Gonçalves Marinho Couto ◽  
Andrea Gazzinelli
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Hospital Environment ◽  
Automated System ◽  
Healthcare Associated Infections ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Hospital Infection Control ◽  
Carbapenemase Gene ◽  
Epidemiological Profile ◽  
Healthcare Associated

ABSTRACT Objective: To study the epidemiological profile of Healthcare-associated Infections caused by Enterobacteria which carry the Klebsiella pneumoniae Carbapenemase gene (blaKPC) in the hospital environment. Method: A descriptive study was conducted in a private hospital in Belo Horizonte, MG, Brazil, which included all patients with infections caused by Enterobacteriaceae which carry the Klebsiella pneumoniae Carbapenemase gene. The data were collected by the Automated System of Hospital Infection Control and analyzed by descriptive statistics by the Epi Info 7 program. Results: Eighty-two (82) patients participated in the study. Klebsiella pneumoniae was the most frequent species (68%) isolated in blood (30%), bronchoalveolar lavage (22%) and urine (18%), while catheter-associated bloodstream infection (30%) predominated regarding topography. A case fatality rate of 62% is highlighted in evaluating the outcome. Conclusion: The resistance genes spread rapidly, limiting the antimicrobial options for treating infectious diseases. The epidemiological profile of Healthcare-Associated Infections found in this study can be prevented by prevention and infection control programs.

scholarly journals In Vitro Susceptibility of Multi-Drug Resistant Klebsiellapneumoniae Strains Causing Nosocomial Infections to Fosfomycin. A Comparison of Determination Methods

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 512
Author(s):  
Beata Mączyńska ◽  
Justyna Paleczny ◽  
Monika Oleksy-Wawrzyniak ◽  
Irena Choroszy-Król ◽  
Marzenna Bartoszewicz
Keyword(s):  
Klebsiella Pneumoniae ◽  
Nosocomial Infections ◽  
Reference Method ◽  
Multidrug Resistant ◽  
Automated System ◽  
Diffusion Method ◽  
In Vitro Susceptibility ◽  
The Phoenix

Introduction: Over the past few decades, Klebsiella pneumoniae strains increased their pathogenicity and antibiotic resistance, thereby becoming a major therapeutic challenge. One of the few available therapeutic options seems to be intravenous fosfomycin. Unfortunately, the determination of sensitivity to fosfomycin performed in hospital laboratories can pose a significant problem. Therefore, the aim of the present research was to evaluate the activity of fosfomycin against clinical, multidrug-resistant Klebsiella pneumoniae strains isolated from nosocomial infections between 2011 and 2020, as well as to evaluate the methods routinely used in hospital laboratories to assess bacterial susceptibility to this antibiotic. Materials and Methods: 43 multidrug-resistant Klebsiella strains isolates from various infections were tested. All the strains had ESBL enzymes, and 20 also showed the presence of carbapenemases. Susceptibility was determined using the diffusion method (E-test) and the automated system (Phoenix), which were compared with the reference method (agar dilution). Results: For the reference method and for the E-test, the percentage of strains sensitive to fosfomycin was 65%. For the Phoenix system, the percentage of susceptible strains was slightly higher and stood at 72%. The percentage of fosfomycin-resistant strains in the Klebsiella carbapenemase-producing group was higher (45% for the reference method and E-test and 40% for the Phoenix method) than in carbapenemase-negative strains (25%, 25%, and 20%, respectively). Full (100%) susceptibility categorical agreement was achieved for the E-test and the reference method. Agreement between the automated Phoenix system and the reference method reached 86%. Conclusions: Fosfomycin appears to be the antibiotic with a potential for use in the treatment of infections with multidrug-resistant Klebsiella strains. Susceptibility to this drug is exhibited by some strains, which are resistant to colistin and carbapenems. The E-test, unlike the Phoenix method, can be an alternative to the reference method in the routine determination of fosfomycin susceptibility, as it shows agreement in terms of sensitivity categories and only slight differences in MIC values. The Phoenix system, in comparison to the reference method, shows large discrepancies in the MIC values and in the susceptibility category.

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