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.

Characterization of multidrug-resistant and virulent Klebsiella pneumoniae strains belonging to the high-risk clonal group 258 (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 ◽  
Multidrug Resistant ◽  
Northeastern Brazil ◽  
Clonal Group

scholarly journals S. pseudintermedius and S. aureus lineages with transmission ability circulate as causative agents of infections in pets for years

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Laura Ruiz-Ripa ◽  
Carmen Simón ◽  
Sara Ceballos ◽  
Carmelo Ortega ◽  
Myriam Zarazaga ◽  
...  
Keyword(s):  
Treatment Options ◽  
Companion Animals ◽  
Clinical History ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Antimicrobial Resistance Profile ◽  
Causative Agents ◽  
Veterinary Hospital ◽  
Coagulase Positive Staphylococci

Abstract Background Staphylococcus pseudintermedius (SP) and Staphylococcus aureus (SA) are common colonizers of companion animals, but they are also considered opportunistic pathogens, causing diseases of diverse severity. This study focused on the identification and characterization of 33 coagulase-positive staphylococci isolated from diseased pets (28 dogs and five cats) during 2009–2011 in a veterinary hospital in Spain in order to stablish the circulating lineages and their antimicrobial resistance profile. Results Twenty-eight isolates were identified as SP and five as SA. Nine methicillin-resistant (MR) isolates (27%) carrying the mecA gene were detected (eight MRSP and one MRSA). The 55% of SP and SA isolates were multidrug-resistant (MDR). MRSP strains were typed as ST71-agrIII-SCCmecII/III-(PFGE) A (n=5), ST68-agrIV-SCCmecV-B1/B2 (n=2), and ST258-agrII-SCCmecIV-C (n=1). SP isolates showed resistance to the following antimicrobials [percentage of resistant isolates/resistance genes]: penicillin [82/blaZ], oxacillin [29/mecA] erythromycin/clindamycin [43/erm(B)], aminoglycosides [18–46/aacA-aphD, aphA3, aadE], tetracycline [71/tet(M), tet(K)], ciprofloxacin [29], chloramphenicol [29/catpC221], and trimethoprim-sulfamethoxazole [50/dfrG, dfrK]. The dfrK gene was revealed as part of the radC-integrated Tn559 in two SP isolates. Virulence genes detected among SP isolates were as follow [percentage of isolates]: siet [100], se-int [100], lukS/F-I [100], seccanine [7], and expB [7]. The single MRSA-mecA detected was typed as t011-ST398/CC398-agrI-SCCmecV and was MDR. The methicillin-susceptible SA isolates were typed as t045-ST5/CC5 (n=2), t10576-ST1660 (n=1), and t005-ST22/CC22 (n=1); the t005-ST22 feline isolate was PVL-positive and the two t045-ST45 isolates were ascribed to Immune Evasion Cluster (IEC) type F. Moreover, the t10576-ST1660 isolate, of potential equine origin, harbored the lukPQ and scneq genes. According to animal clinical history and data records, several strains seem to have been acquired from different sources of the hospital environment, while some SA strains appeared to have a human origin. Conclusions The frequent detection of MR and MDR isolates among clinical SP and SA strains with noticeable virulence traits is of veterinary concern, implying limited treatment options available. This is the first description of MRSA-ST398 and MRSP-ST68 in pets in Spain, as well the first report of the dfrK-carrying Tn559 in SP. This evidences that current transmissible lineages with mobilizable resistomes have been circulating as causative agents of infections among pets for years.

scholarly journals Clinical Specimens are the Pool of oprL and toxA Virulence Genes Harboring Multidrug-Resistant Pseudomonas aeruginosa: Findings from a Tertiary Hospital of Nepal

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yamuna Chand ◽  
Sujan Khadka ◽  
Sanjeep Sapkota ◽  
Suprina Sharma ◽  
Santosh Khanal ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Susceptibility ◽  
Virulence Genes ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Settings ◽  
Global Public Health ◽  
Clinical Specimens ◽  
First Time

The multidrug- or extensively drug-resistant (MDR/XDR) Pseudomonas aeruginosa carrying some virulence genes has become a global public health threat. However, in Nepal, there is no existing report showing the prevalence of oprL and toxA virulence genes among the clinical isolates of P. aeruginosa. Therefore, this study was conducted for the first time in the country to detect the virulence genes (oprL and toxA) and antibiotic susceptibility pattern of P. aeruginosa. A total of 7,898 clinical specimens were investigated following the standard microbiological procedures. The antibiotic susceptibility testing was examined by the modified disc diffusion method, and virulence genes oprL and toxA of P. aeruginosa were assessed using multiplex PCR. Among the analyzed specimens, 87 isolates were identified to be P. aeruginosa of which 38 (43.68%) isolates were reported as MDR. A higher ratio of P. aeruginosa was detected from urine samples 40 (45.98%), outpatients’ specimens 63 (72.4%), and in patients of the age group of 60–79 years 36 (41.37%). P. aeruginosa was more prevalent in males 56 (64.36%) than in female patients 31 (35.63%). Polymyxin (83.90%) was the most effective antibiotic. P. aeruginosa (100%) isolates harboured the oprL gene, while 95.4% of isolates were positive for the toxA gene. Identification of virulence genes such as oprL and toxA carrying isolates along with the multidrug resistance warrants the need for strategic interventions to prevent the emergence and spread of antimicrobial resistance (AMR). The findings could assist in increasing awareness about antibiotic resistance and suggest the judicious prescription of antibiotics to treat the patients in clinical settings of Nepal.

Spread of multidrug-resistant high-risk Klebsiella pneumoniae clones in a tertiary hospital from southern Brazil

2017 ◽  
Vol 56 ◽  
pp. 1-7 ◽  
Author(s):  
Guilherme Bartolomeu Gonçalves ◽  
João Pedro Rueda Furlan ◽  
Eliana Carolina Vespero ◽  
Marsileni Pelisson ◽  
Eliana Guedes Stehling ◽  
...  
Keyword(s):  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Southern Brazil

scholarly journals Co-occurrence of blaNDM–1 and mcr-9 in a Conjugative IncHI2/HI2A Plasmid From a Bloodstream Infection-Causing Carbapenem-Resistant Klebsiella pneumoniae

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhou Liu ◽  
Xiubin Hang ◽  
Xiao Xiao ◽  
Wenwen Chu ◽  
Xin Li ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Galleria Mellonella ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Global Public Health ◽  
Colistin Resistance ◽  
Structural Variations ◽  
Single Chromosome ◽  
Antimicrobial Resistance Genes

Spread of the carbapenemase-encoding and mobilized colistin resistance (mcr) genes among Enterobacteriales poses a great threat to global public health, especially when the both genes are transferred by a single plasmid. Here, we identified a blaNDM–1- and mcr-9-co-encoding plasmid harbored by a clinical isolate of Klebsiella pneumoniae (KPN710429). KPN710429 was recovered from a blood sample from an inpatient in a tertiary hospital in China, and antimicrobial susceptibility testing showed that it was multidrug-resistant and only susceptible to aztreonam, colistin, and tigecycline. KPN710429 belongs to sequence type (ST) 1308 and capsular serotype KL144. The string test of KPN710429 was negative, and this strain didn’t exhibit a hypervirulent phenotype according to serum-killing and Galleria mellonella lethality assessments. Whole-genome sequencing revealed the KPN710429 genome comprises a single chromosome and three plasmids. All virulence associated genes were harbored by chromosome. Most of its antimicrobial resistance genes, including blaNDM–1 and mcr-9 were carried by plasmid pK701429_2, belonging to the incompatibility (Inc) HI2/HI2A group and ST1. Comparative genomics assays indicates that pK710429_2 could be a hybrid plasmid, formed by a Tn6696-like blaNDM–1 region inserting into a mcr-9-positive-IncHI2/HI2A plasmid. pK710429_2 contained the conjugative transfer gene regions, Tra1 and Tra2, with some structural variations, and conjugation assays revealed that pK710429_2 was transferable. Although pK710429_2 lacked the qseB-qseC regulatory genes, mcr-9 expression was upregulated after pretreatment with colistin for 6 h, leading to colistin resistance in KPN710429. To our knowledge, this is the first report of a blaNDM–1- and mcr-9-co-encoding transferable plasmid harbored by a bloodstream-infection-causing K. pneumoniae strain in China. Effective surveillance should be implemented to assess the prevalence of the plasmid co-harboring carbapenemase-encoding gene and mcr-9.

scholarly journals The Characterization of OXA-232 Carbapenemase-Producing ST437 Klebsiella pneumoniae in China

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Xingbei Weng ◽  
Qiucheng Shi ◽  
Sheng Wang ◽  
Yubo Shi ◽  
Dinghe Sun ◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Clonal Complex ◽  
Multidrug Resistant ◽  
New Delhi ◽  
Carbapenem Resistant ◽  
The World ◽  
Global Threat

Carbapenem-resistant Klebsiella pneumoniae (CRKP) was epidemic around the world and become a global threat to public health. The most important carbapenem-resistant mechanism is producing carbapenemases, especially Klebsiella pneumoniae carbapenemase (KPC), which is prevalent in the international clonal complex CC11. The high-risk multidrug-resistant CC11 is widespread worldwide, and KPC-producing and (New Delhi metallo) NDM-producing strains had been reported in this clonal complex before; moreover, cases with the CC11 strain faced more severe forms of drug resistance and treatment challenges than other clonal complexes. In this study, we identified an OXA-232-producing ST437 Klebsiella pneumoniae isolate in China, which belonged to CC11. The isolate was resistant to β-lactams, aminoglycosides, and fluoroquinolones but susceptible to fosfomycin, tigecycline, and colistin. The blaOXA-232 gene was located on a 6141 bp ColKP3-type nonconjugative plasmid, and the plasmid was transformed by chemical transformation successfully. This is the first report of OXA-232-producing ST437 K. pneumoniae in China, a new clone of high-risk multidrug-resistant CC11.

High prevalence of carbapenem-resistant Klebsiella pneumoniae ST307 recovered from fecal samples in an Italian hospital

2021 ◽  
Author(s):  
Gloria Magi ◽  
Federica Tontarelli ◽  
Sara Caucci ◽  
Laura Di Sante ◽  
Andrea Brenciani ◽  
...  
Keyword(s):  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Antibiotic Susceptibility ◽  
Multidrug Resistant ◽  
Pfge Analysis ◽  
Fecal Samples ◽  
Carbapenem Resistant ◽  
High Prevalence ◽  
Stool Samples

Aim: This study reports the characterization of carbapenem-resistant colonizing strains of K. pneumoniae. Methods: 650 stool samples were screened for carbapenem-resistant K. pneumoniae (CR-Kp). All strains were characterized for antibiotic susceptibility, typing features, main carbapenemases and extended-spectrum ß-lactamases. The carbapenemase transferability was assessed by interspecific conjugation. Results: Eighteen CR-Kp were multidrug resistant, five were KPC producing. A predominance of ST307 isolates, constituting the predominant cluster by PFGE analysis, was identified (50% were KPC-2 producers). Conjugation data showed the co-transfer of blaKPC-2, blaTEM-1, blaOXA-1, blaCTX-M-15 in a single large pKPN3-like plasmid. Conclusion: Our data pointed out the diversity of colonizing K. pneumoniae strains compared with clinical ones. The predominance of ST307 strains suggested an increased spreading, even in our area, of this high-risk clone.

scholarly journals Molecular Characterization of Carbapenemase Producing Klebsiella Pneumoniae Dominance of OXA-48, KPC, VIM and NDM Producers in Khartoum, Sudan

2017 ◽  
Vol 2 (3) ◽  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Clinical Samples ◽  
Medical Laboratories ◽  
Molecular Microbiology ◽  
Diffusion Technique ◽  
Carbapenemase Gene ◽  
First Time

Background and Objectives: Little is known about carbapenemase producing Klebsiella pneumoniae (CPK) in Sudan. This study aimed to determine the prevalence of CPK in a major hospital in Khartoum, Sudan between may 2015 - January 2017 and to characterize the isolates and detect the types of carbapenemase (s) they produced. Materials and Methods: The study was done in the Department of Molecular Microbiology, Faculty of Medical Laboratories Science, Al-Neleen University. All the isolates were obtained from clinical samples of patients treated inside the hospitals. Strains of K. pneumoniae resistant to at least one carbapenem (imipenem or meropenem) by using disc diffusion technique according to the CLSI guidelines were included in this study. Molecular detection of carbapenemase genes was achieved using Real-Time PCR (Sacace Biotechnologie, Italie). Results: A total 96 strains of K. pneumoniae of different non duplicated isolates were obtained from different hospitals. Seventy-two percent (70/96) isolates were positive for carbapenemase genes; 59.4% (57/96) were positive for blaKPC genes, 57.3% (55/96) were positive for blaNDM genes, 37.5% (36/96) were positive for blaVIM genes and 35.4% (34/96) were positive for blaOXA-48 genes. Nineteen isolates possessed four genes (blaKPC, blaNDM, blaVIM and blaOXA-48), fourteen isolates possessed three genes{( blaNDM, blaVIM and blaOXA-48=6), (blaKPC, blaNDM, and blaOXA-48=3), (blaKPC, blaNDM and blaVIM =3), (blaKPC, blaVIM and blaOXA-48=2)}, 27 isolates possessed two genes{( blaKPC and blaNDM =21), (blaKPC, blaOXA-48=2), (blaNDM and blaVIM =3), (blaNDM and blaOXA-48=1)}, 10 isolates possessed only one gene (blaKPC =8, blaOXA-48=1 and blaVIM =1) and the remaining 26 isolates were free from these genes. Conclusion & Recommendation: In Sudan, the most common type of carbapenemase gene multidrug-resistant K. pneumoniae is KPC. Co-production of KPC, VIM, NDM and OXA-48 genes are found in K. pneumoniae. To our knowledge, this study was done for the first time in Sudan. Therefore, it is necessary to determine carbapenem resistance in K. pneumoniae isolates and take essential infection control precautions to avoid spread of this resistance.

scholarly journals Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

2019 ◽  
Author(s):  
Kern Rei Chng ◽  
Chenhao Li ◽  
Denis Bertrand ◽  
Amanda Hui Qi Ng ◽  
Junmei Samantha Kwah ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Antibiotic Resistance Genes ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Ecological Niches ◽  
Metagenomic Sequencing ◽  
Resistant Strains

AbstractThere is growing attention surrounding hospital acquired infections (HAIs) due to high associated healthcare costs, compounded by the scourge of widespread multi-antibiotic resistance. Although hospital environment disinfection is well acknowledged to be key for infection control, an understanding of colonization patterns and resistome profiles of environment-dwelling microbes is currently lacking. We report the first extensive genomic characterization of microbiomes (428), common HAI-associated microbes (891) and transmissible drug resistance cassettes (1435) in a tertiary hospital environment based on a 3-timepoint sampling (1 week and >1 year apart) of 179 sites from 45 beds. Deep shotgun metagenomic sequencing unveiled two distinct ecological niches of microbes and antibiotic resistance genes characterized by biofilm-forming and human microbiome influenced environments that display corresponding patterns of divergence over space and time. To study common nosocomial pathogens that were typically present at low abundances, a combination of culture enrichment and long-read nanopore sequencing was used to obtain thousands of high contiguity genomes (2347), phage sequences (1693) and closed plasmids (5910), a significant fraction of which (>60%) are not represented in current sequence databases. These high-quality assemblies and metadata enabled a rich characterization of resistance gene combinations, phage diversity, plasmid architectures, and the dynamic nature of hospital environment resistomes and their reservoirs. Phylogenetic analysis identified multidrug resistant strains as being more widely distributed and stably colonizing across hospital sites. Further genomic comparisons with clinical isolates across multiple species supports the hypothesis that multidrug resistant strains can persist in the hospital environment for extended periods (>8 years) to opportunistically infect patients. These findings highlight the importance of characterizing antibiotic resistance reservoirs in the hospital environment and establishes the feasibility of systematic genomic surveys to help target resources more efficiently for preventing HAIs.

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