scholarly journals Detection of Several Carbapenems Resistant and Virulence Genes in Classical and Hyper-virulent Strains of Klebsiella pneumoniae Isolated from Hospitalized Neonates and Adults in Khartoum

2020 ◽  
Author(s):  
Aalaa Mahgoub Albasha ◽  
Esraa Hassan Osman ◽  
Saga Abd Alhalim ◽  
Elianz Alshaib ◽  
Leena Al-Hassan ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Virulence Genes ◽  
Age Groups ◽  
Hospitalized Patients ◽  
High Rate ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Resistant Genes ◽  
Virulent Strains ◽  
Wide Range

Abstract Background Carbapenems resistant hypervirulent strains of Klebsiella pneumoniae are one of the most critical organisms that cause fatal nosocomial infections. This study aimed to detect and characterize K. pneumoniae virulence genes (mrkD, entB, rmpA, K2, kfu, and magA) and carbapenem resistant (blaNDM, blaIMP, blaOXA−48, and blaKPC) genes Methods Sixty K. pneumoniae strains were isolated from urine, blood, wound swab, and sputum samples, in two age groups: neonates and adults. String test was used to detect hypervirulent strains. Susceptibility testing for a wide range of antibiotics was performed on all isolates. DNA was extracted by the guanidine chloride method, then multiplex PCR was used for the detection of carbapenem-resistance and virulence genes. Results Seventy percent of the isolates were resistant to ceftazidime and 8% to imipenem, 35% were multi-drug resistant, and 7% extensively drug-resistant, all neonatal blood isolates (n = 15) were resistant to ceftazidime. entB was the most predominant virulence gene (93.3%), followed by mrkD (78.3%), kfu (60%), K2 (51.7%), magA (18.3%) and rmpA (5%). blaOXA−48 was the most predominant carbapenem-resistant gene (68.3%), followed by blaNDM (10%), blaKPC (8.3%), and blaIMP (3.3%). Eight hyper-virulent strains were positive for blaOXA−48 and two for blaNDM genes. The study concluded that there is a high rate of carbapenems resistant genes in hyper-virulent strains of K. pneumoniae isolated from hospitalized patients. Conclusion The study reported for the first time in Sudan presence of carbapenems resistant genes in hyper-virulent strains of K. pneumoniae isolated from hospitalized patients. Presence of MDR and XDR strains of K. pneumoniae in neonatal ward in some Sudanese hospitals.

scholarly journals Detection of Several Carbapenems Resistant and Virulence Genes in Classical and Hyper-virulent Strains of Klebsiella pneumoniae Isolated from Hospitalized Neonates and Adults in Khartoum

2020 ◽  
Author(s):  
Aalaa Mahgoub Albasha ◽  
Esraa Hassan Osman ◽  
Saga Abd Alhalim ◽  
Elianz Alshaib ◽  
Leena Al-Hassan ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Virulence Genes ◽  
Age Groups ◽  
Hospitalized Patients ◽  
High Rate ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Resistant Genes ◽  
Virulent Strains ◽  
Wide Range

Abstract Background Carbapenems resistant hypervirulent strains of Klebsiella pneumoniae are one of the most critical organisms that cause fatal nosocomial infections. This study aimed to detect and characterize K. pneumoniae virulence genes (mrkD, entB, rmpA, K2, kfu, and magA) and carbapenem resistant (blaNDM, blaIMP, blaOXA−48, and blaKPC) genes Methods Sixty K. pneumoniae strains were isolated from urine, blood, wound swab, and sputum samples, in two age groups: neonates and adults. String test was used to detect hypervirulent strains. Susceptibility testing for a wide range of antibiotics was performed on all isolates. DNA was extracted by the guanidine chloride method, then multiplex PCR was used for the detection of carbapenem-resistance and virulence genes. Results Seventy percent of the isolates were resistant to ceftazidime and 8% to imipenem, 35% were multi-drug resistant, and 7% extensively drug-resistant, all neonatal blood isolates (n = 15) were resistant to ceftazidime. entB was the most predominant virulence gene (93.3%), followed by mrkD (78.3%), kfu (60%), K2 (51.7%), magA (18.3%) and rmpA (5%). blaOXA−48 was the most predominant carbapenem-resistant gene (68.3%), followed by blaNDM (10%), blaKPC (8.3%), and blaIMP (3.3%). Eight hyper-virulent strains were positive for blaOXA−48 and two for blaNDM genes. The study concluded that there is a high rate of carbapenems resistant genes in hyper-virulent strains of K. pneumoniae isolated from hospitalized patients. Conclusion The study reported for the first time in Sudan presence of carbapenems resistant genes in hyper-virulent strains of K. pneumoniae isolated from hospitalized patients. Presence of MDR and XDR strains of K. pneumoniae in neonatal ward in some Sudanese hospitals.

scholarly journals Detection of Several Carbapenems Resistant and Virulence Genes in Classical and Hyper-virulent Strains of Klebsiella pneumoniae Isolated from Hospitalized Neonates and Adults in Khartoum

2020 ◽  
Author(s):  
Aalaa Mahgoub Albasha ◽  
Esraa Hassan Osman ◽  
Saga Abd Alhalim ◽  
Elianz Alshaib ◽  
Leena Al-Hassan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Nosocomial Infections ◽  
Virulence Genes ◽  
Virulence Gene ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Extensively Drug Resistant ◽  
Virulent Strains

Abstract Objective Klebsiella pneumoniae (K. pneumoniae) involves both community-acquired and nosocomial infections. It is responsible for a wide variety of infections, including infections of the urinary tract, pneumonia, bacteremia, meningitis, wound infection and purulent abscesses. We constructed this study to detect several carbapenems resistant and virulence genes in classical and hyper-virulent strains of K. pneumoniae isolated from hospitalized neonates and adults in Khartoum state. Results Seventy percent of the isolates were resistant to ceftazidime, 18(30%) to ciprofloxacin, 23(38.3%) to chloramphenicol, 24(40%) to gentamicin and 8% to imipenem, 35% were multidrug-resistant, and 7% extensively drug-resistant, all blood isolates (n=14) were resistant to ceftazidime. entB was the most predominant virulence gene (93.3%), followed by mrkD (78.3%), kfu (60%), K2 (51.7%), magA (18.3%) and rmpA (5%). blaOXA-48 was the most predominant carbapenem-resistant gene (68.3%), followed by blaNDM (10%), blaKPC (8.3%), and blaIMP (3.3%). Eight hyper-virulent strains were positive for blaOXA-48 and two for blaNDM genes.

scholarly journals Detection of Several Carbapenems Resistant and Virulence Genes in Classical and Hyper-virulent Strains of Klebsiella Pneumoniae Isolated From Hospitalized Neonates and Adults in Khartoum

2020 ◽  
Author(s):  
Aalaa Mahgoub Albasha ◽  
Esraa Hassan Osman ◽  
Saga Abd Alhalim ◽  
Elianz Alshaib ◽  
Leena Al-Hassan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Nosocomial Infections ◽  
Virulence Genes ◽  
Virulence Gene ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Extensively Drug Resistant ◽  
Virulent Strains ◽  
Neonatal Blood

Abstract ObjectiveKlebsiella pneumoniae (K. pneumoniae) involves both community-acquired infections and nosocomial infections. It is responsible for a wide variety of infections including infections of the urinary tract, pneumonia, bacteremia, meningitis, wound infection and purulent abscesses. We constructed this study to detect several carbapenems resistant and virulence genes in classical and hyper-virulent strains of K. pneumoniae isolated from hospitalized neonates and adults in Khartoum state. ResultsSeventy percent of the isolates were resistant to ceftazidime and 8% to imipenem, 35% were multi-drug resistant, and 7% extensively drug-resistant, all neonatal blood isolates (n=15) were resistant to ceftazidime. entB was the most predominant virulence gene (93.3%), followed by mrkD (78.3%), kfu (60%), K2 (51.7%), magA (18.3%) and rmpA (5%). blaOXA-48 was the most predominant carbapenem-resistant gene (68.3%), followed by blaNDM (10%), blaKPC (8.3%), and blaIMP (3.3%). Eight hyper-virulent strains were positive for blaOXA-48 and two for blaNDM genes.

scholarly journals Genetic Characterisation of Colistin Resistant Klebsiella pneumoniae Clinical Isolates From North India

2021 ◽  
Vol 11 ◽  
Author(s):  
Sanjay Singh ◽  
Ashutosh Pathak ◽  
Mohibur Rahman ◽  
Avinash Singh ◽  
Soumyabrata Nag ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Virulence Genes ◽  
Efflux Pumps ◽  
Clinical Isolates ◽  
North India ◽  
Drug Resistant ◽  
Colistin Resistance ◽  
Genomic Plasticity ◽  
Resistant Genes ◽  
Sequence Types

BackgroundIncreasing use of colistin has led to the world-wide emergence of mobile colistin resistant gene (mcr). The present study aimed to identify and characterise mcr and other drug-resistant genes in colistin resistant Klebsiella pneumoniae clinical isolates.MethodsTwenty-two colistin resistant K. pneumoniae were analysed for mcr and other drug-resistant genes, efflux pumps, and virulence genes, and for their biofilm forming ability. Pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were performed for all mcr-1 positive isolates. S1-PFGE and Southern hybridisation were performed for localisation of mcr-1 and blaNDM.ResultsNineteen colistin resistant K. pneumoniae harboured mcr-1 and 3 had mgrB disruption. All isolates harboured blaOXA-48-type and ESBL genes; eight strains (five with mcr-1 and three with mgrB disruption) co-harboured blaNDM. Efflux pumps genes AcrAB and mdtK were detected in all 22 and tol-C in 21 isolates. Virulence-related genes entB and irp-1 were detected in all 22, mrkD in 20, and fimH-1 in 18 isolates; 11 isolates were strong biofilm producers. PFGE clustered mcr-1 positive isolates into eight groups based on ≥90% similarity; MLST revealed diverse sequence types, predominant being ST-15 (n = 4) and ST-16 (n = 4). Both mcr-1 and blaNDM were localised on plasmid and chromosome; mcr-1 was present on IncFII type and blaNDM on IncFIB and IncA/C type plasmids.ConclusionsColistin resistance in K. pneumoniae was predominantly mediated by mcr-1. Co-existence of colistin, carbapenem, and other drug-resistant genes along with efflux pumps indicates towards enormous genomic plasticity in K. pneumoniae with ability to emerge as super-spreader of drug-resistance.

Decreased carO gene expression and OXA-type carbapenemases among extensively drug-resistant Acinetobacter baumannii strains isolated from burn patients in Tehran, Iran

2020 ◽  
Author(s):  
Elham Abbasi ◽  
Hossein Goudarzi ◽  
Ali Hashemi ◽  
Alireza Salimi Chirani ◽  
Abdollah Ardebili ◽  
...  
Keyword(s):  
Gene Expression ◽  
Acinetobacter Baumannii ◽  
High Rate ◽  
Burn Patients ◽  
Drug Resistant ◽  
Disc Diffusion ◽  
Carbapenem Resistant ◽  
Extensively Drug Resistant ◽  
Sds Page ◽  
Extensively Drug Resistance

AbstractA major challenge in the treatment of infections has been the rise of extensively drug resistance (XDR) and multidrug resistance (MDR) in Acinetobacter baumannii. The goals of this study were to determine the pattern of antimicrobial susceptibility, blaOXA and carO genes among burn-isolated A. baumannii strains. In this study, 100 A. baumannii strains were isolated from burn patients and their susceptibilities to different antibiotics were determined using disc diffusion testing and broth microdilution. Presence of carO gene and OXA-type carbapenemase genes was tested by PCR and sequencing. SDS-PAGE was done to survey CarO porin and the expression level of carO gene was evaluated by Real-Time PCR. A high rate of resistance to meropenem (98%), imipenem (98%) and doripenem (98%) was detected. All tested A. baumannii strains were susceptible to colistin. The results indicated that 84.9% were XDR and 97.9% of strains were MDR. In addition, all strains bore blaOXA-51 like and blaOXA-23 like and carO genes. Nonetheless, blaOXA-58 like and blaOXA-24 like genes were harbored by 0 percent and 76 percent of strains, respectively. The relative expression levels of the carO gene ranged from 0.06 to 35.01 fold lower than that of carbapenem-susceptible A. baumannii ATCC19606 and SDS – PAGE analysis of the outer membrane protein showed that all 100 isolates produced CarO. The results of current study revealed prevalence of blaOXA genes and changes in carO gene expression in carbapenem resistant A.baumannii.

scholarly journals Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Western Chongqing, China

2022 ◽  
Vol 11 ◽  
Author(s):  
Wan Huang ◽  
Jisheng Zhang ◽  
Lingyi Zeng ◽  
Chengru Yang ◽  
Lining Yin ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Klebsiella Pneumoniae ◽  
Virulence Genes ◽  
Resistance Rate ◽  
Molecular Characteristics ◽  
Chain Reaction ◽  
Detection Rates ◽  
Carbapenem Resistant ◽  
Polymerase Chain ◽  
Epidemiological Characteristics

BackgroundThis study aimed to determine the molecular characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in a hospital in western Chongqing, southwestern China.MethodsA total of 127 unique CRKP isolates were collected from the Yongchuan Hospital of Chongqing Medical University, identified using a VITEK-2 compact system, and subjected to microbroth dilution to determine the minimal inhibitory concentration. Enterobacteriaceae intergenic repeat consensus polymerase chain reaction and multilocus sequence typing were used to analyze the homology among the isolates. Genetic information, including resistance and virulence genes, was assessed using polymerase chain reaction. The genomic features of the CRKP carrying gene blaKPC-2 were detected using whole-genome sequencing.ResultsST11 was the dominant sequence type in the homology comparison. The resistance rate to ceftazidime-avibactam in children was much higher than that in adults as was the detection rate of the resistance gene blaNDM (p < 0.0001). Virulence genes such as mrkD (97.6%), uge (96.9%), kpn (96.9%), and fim-H (84.3%) had high detection rates. IncF (57.5%) was the major replicon plasmid detected, and sequencing showed that the CRKP063 genome contained two plasmids. The plasmid carrying blaKPC-2, which mediates carbapenem resistance, was located on the 359,625 base pair plasmid IncFII, together with virulence factors, plasmid replication protein (rep B), stabilizing protein (par A), and type IV secretion system (T4SS) proteins that mediate plasmid conjugation transfer.ConclusionOur study aids in understanding the prevalence of CRKP in this hospital and the significant differences between children and adults, thus providing new ideas for clinical empirical use of antibiotics.

scholarly journals High Frequency of Multidrug-resistant (Mdr) Klebsiella Pneumoniae Harboring Several β-lactamase and Integron Genes Collected From Several Hospitals in the North of Iran

2021 ◽  
Author(s):  
Mojgan Farhadi ◽  
Mohammad Ahanjan ◽  
Hamid Reza Goli ◽  
Mohammad Reza Haghshenas ◽  
Mehrdad Gholami
Keyword(s):  
Klebsiella Pneumoniae ◽  
Resistance Genes ◽  
Antimicrobial Susceptibility ◽  
Hospitalized Patients ◽  
Clinical Samples ◽  
High Morbidity ◽  
Drug Resistant ◽  
The North ◽  
Agar Diffusion Test ◽  
North Of Iran

Abstract Background: Klebsiella pneumoniae is one of the leading causes of hospital outbreaks worldwide. Also, antibiotic-resistant K. pneumoniae is progressively being involved in invasive infections with high morbidity and mortality. The aim of the current study was to determine antimicrobial susceptibility patterns and the incidences of resistance genes (integron types and β-lactamase-encoded genes) among clinical isolates of K. pneumoniae. Methods: In this cross-sectional study, a total of 100 clinical samples were obtained from hospitalized patients in three teaching hospitals in the north of Iran, from November 2018 and October 2019. Antimicrobial susceptibility testing was performed using disk agar diffusion test in line with CLSI recommendation. For colistin, minimum inhibitory concentration (MIC) was determined using broth microdilution. Based on antibiogram, multi-drug resistant (MDR) and extensive-drug resistant (XDR) strains were detected. Finally, integron types and β-lactamase resistance genes were identified using polymerase chain reaction technique.Results. The most and least clinical samples were related to the urine and bronchoalveolar lavage, respectively. Based on the antibiogram results, amikacin and gentamicin exhibited good activity against K. pneumoniae strains in vitro. High resistance rate (93%) to ampicillin/sulbactam also predict the limited efficacy of this antibiotic. Among all the 100 isolates, the frequency of MDR and XDR strains were 58% and 13%, respectively, while no pan-drug resistant (PDR) isolates were found. The prevalence of blaSHV, blaTEM, blaCTX-M-15, blaKPC, blaOXA-48, blaNDM β-lactamase genes were 91.4%, 82.7%, 79.3%, 29.3%, 36.2% and 6.9%, respectively, however 58% of the isolates were carrying intI gene. Class II and III integrons were not detected in any isolates. Conclusion: The MDR K. pneumoniae is becoming a serious problem in hospitals, with many strains developing resistance to most available antimicrobials. Our results indicate co-presence of a series of β-lactamase and integron types on the MDR strains recovered from hospitalized patients. The increasing rate of these isolates emphasizes the importance of choosing an appropriate antimicrobial regimen based on antibiotic susceptibility pattern.

scholarly journals Review of therapeutic options for infections with carbapenem-resistant Klebsiella pneumoniae

2020 ◽  
Vol 10 (3) ◽  
pp. 115-124
Author(s):  
Rasmus G. Bandick ◽  
Soraya Mousavi ◽  
Stefan Bereswill ◽  
Markus M. Heimesaat
Keyword(s):  
Clinical Trials ◽  
Klebsiella Pneumoniae ◽  
Control Treatment ◽  
Drug Resistant ◽  
Treatment Regimens ◽  
Combined Application ◽  
Carbapenem Resistant ◽  
Antibiotic Compounds ◽  
Life Threatening

AbstractInfections with multi-drug resistant (MDR) bacteria including carbapenem-resistant Klebsiella pneumoniae are emerging worldwide but are difficult to treat with the currently available antibiotic compounds and therefore constitute serious threats to human health. This prompted us to perform a literature survey applying the MEDLINE database and Cochrane Register of Controlled Trials including clinical trials comparing different treatment regimens for infections caused by carbapenem-resistant K. pneumoniae. Our survey revealed that a combined application of antibiotic compounds such as meropenem plus vaborbactam, meropenem plus colistin and carbapenem plus carbapenem, resulted in significantly increased clinical cure and decreased mortality rates as compared to respective control treatment. However, further research on novel antibiotic compounds, but also on antibiotic-independent molecules providing synergistic or at least resistance-modifying properties needs to be undertaken in vitro as well as in large clinical trials to provide future options in the combat of emerging life-threatening infections caused by MDR bacteria.

Detection of extensively drug-resistant and hypervirulent Klebsiella pneumoniae ST15, ST147, ST377 and ST442 in Iran

2021 ◽  
Author(s):  
Sara Davoudabadi ◽  
Hossein Goudarzi ◽  
Mehdi Goudarzi ◽  
Abdollah Ardebili ◽  
Ebrahim Faghihloo ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Pcr Amplification ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Extensively Drug Resistant ◽  
String Test ◽  
Pcr Method ◽  
Extensively Drug Resistance

Abstract In this study, we focused on the emergence of extensively drug-resistant (XDR), pandrug-resistant (PDR), and hypervirulent Klebsiella pneumoniae (hvKP) in Iran. During 2018 to 2020 a total of 52 K. pneumoniae isolates were collected from different clinical specimens. The hvKP isolates were identified by PCR amplification of virulence and capsular serotype-specific genes. Hypermucoviscous K. pneumoniae (hmKP) were identified by string test. Carbapenem-resistant hvKP (CR-hvKP), multidrug-resistant hvKP (MDR-hvKP), extensively drug-resistant hvKP (XDR-hvKP), and pandrug-resistant hvKP (PDR-hvKP) were determined by disc diffusion method, Carba-NP test and PCR method. XDR-hvKP isolates were typed by multilocus sequence typing (MLST). Among all K. pneumoniae isolates 14 (26.9%) were identified as hvKP and 78.6% (11/14) of them were hmKP however, none of the classic K. pneumoniae (cKP) isolates were hmKP. The predominant capsular serotype of hvKP was K2 (42.85%) followed by K1 (35.71%). The prevalence of MDR-hvKP, XDR-hvKP and PDR-hvKP isolates were 6 (42.9%), 5 (35.7%) and 1 (7.1%), respectively. ESBL production was found in 85.7% of hvKP isolates and most of them carried bla TEM gene (78.6%) and 6 isolates (42.9%) were CR-hvKP. Among hvKP isolates, 1 (7.1%), 2 (14.3%), 3 (21.4%), 8 (28.6%), and 11 (78.6%) carried bla NDM-6, bla OXA-48, bla CTX-M, bla SHV, and bla TEM genes, respectively. According to MLST analysis, 2, 1, 1, and 1 XDR-hvKP isolates belonged to ST15, ST377, ST442, and ST147, respectively. The occurrence of such isolates is deeply concerning due to the combination of hypervirulence and extensively drug-resistance or pandrug-resistance.

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