Molecular Epidemiology of Multidrug-Resistant Klebsiella pneumoniae Isolates in a Brazilian Tertiary Hospital

Introduction. Klebsiella pneumoniae (K. pneumoniae) is one of the leading causes of hospital-acquired and community-acquired infections in the world. This study was conducted to investigate the molecular epidemiology of drug resistance in clinical isolates of K. pneumoniae in Azerbaijan, Iran. Materials and Methods. A total of 100 nonduplicated isolates were obtained from the different wards of Azerbaijan state hospitals, Iran, from 2019 to 2020. Antibiotic susceptibility testing was done. The DNA was extracted, and the PCR for evaluation of the resistance genes was carried out. Results. The highest antibiotic resistance was shown to ampicillin (96%), and the highest susceptibility was shown to tigecycline (9%), and 85% of isolates were multidrug resistant. The most frequent ESBL gene in the tested isolates was blaSHV-1 in 58%, followed by blaCTXM-15 (55%) and blaSHV-11(42%). The qepA, oqxB, and oqxA genes were found to be 95%, 87.5%, and 70%, respectively. We detected tetB in 42%, tetA in 32%, tetD in 21%, and tetC in 16%. Seventy isolates were resistant to co-trimoxazole, and the rate of resistance genes was sul1 in 71%, followed by sul2 (43%), dfr (29%), and sul3 (7%). The most common aminoglycoside resistance genes were ant3Ia, aac6Ib, aph3Ib, and APHs in 44%, 32%, 32%, and 31.4%, respectively. The most frequent resistance gene to fosfomycin was fosA (40%) and fosX (40%) followed by fosC (20%). Conclusion. The results of this study indicate the high frequency of drug resistance among K. pneumoniae isolated from hospitals of Azerbaijan state. The present study shows the presence of high levels of drug-resistant genes in various antibiotics, which are usually used in the treatment of infections due to K. pneumoniae.

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

10.21203/rs.3.rs-436335/v1 ◽

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.

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Tracking Multidrug-Resistant Klebsiella pneumoniae from an Italian Hospital: Molecular Epidemiology and Surveillance by PFGE, RAPD and PCR-Based Resistance Genes Prevalence

Current Microbiology ◽

10.1007/s00284-018-1475-3 ◽

2018 ◽

Vol 75 (8) ◽

pp. 977-987 ◽

Cited By ~ 14

Author(s):

Giancarlo Ripabelli ◽

Manuela Tamburro ◽

Giuliana Guerrizio ◽

Incoronata Fanelli ◽

Romeo Flocco ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Molecular Epidemiology ◽

Resistance Genes ◽

Multidrug Resistant ◽

Italian Hospital

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

Infection Genetics and Evolution ◽

10.1016/j.meegid.2017.10.011 ◽

2017 ◽

Vol 56 ◽

pp. 1-7 ◽

Cited By ~ 11

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

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Molecular epidemiology of community-onset Clostridioides difficile infections at a tertiary hospital in mainland China: A ten-year (2010-2019) retrospective study

10.21203/rs.3.rs-877500/v1 ◽

2021 ◽

Author(s):

Yunbo Chen ◽

Lihong Bu ◽

Tao Lv ◽

Lisi Zheng ◽

Silan Gu ◽

...

Keyword(s):

Molecular Epidemiology ◽

Mainland China ◽

Tertiary Hospital ◽

Multidrug Resistant ◽

Binary Toxin ◽

Common Disease ◽

High Genetic Diversity ◽

Toxin Genes ◽

Clostridioides Difficile ◽

Community Onset

Abstract Background Clostridioides difficile infection (CDI) is an increasingly common disease in healthcare facilities and community settings. However, there are limited reports of community-onset CDI (CO-CDI) in China. We retrospectively analyzed the molecular epidemiology of CO-CDI at a tertiary hospital over a period of 10 years. Methods A total of 1307 stool samples from 1213 outpatients were tested by culturing. The presence of toxin genes (tcd A, tcd B, cdtA and cdtB) were confirmed by PCR. Toxigenic strains were typed using multilocus sequence typing (MLST). Susceptibility to 9 antimicrobials was evaluated using the E-test. Results Eighty-nine of 1213 outpatients (7.3%) had CO-CDI, 4 of these patients (4.5%) had one or more recurrence, and there were 95 strains of toxigenic C. difficile. Among these strains, 82 (86.3%) had the tcdA and tcdB genes (A + B+) and 5 of these 82 strains were positive for the binary toxin genes (cdtA and cdtB); the other 13 strains (13.7%) had the tcdB gene only (A-B+). There were 15 different STs and the most prevalent were ST-54 (23.2%), ST-35 (16.8%), and ST-2 (13.7%). All strains were susceptible to metronidazole and vancomycin, and had low resistance to moxifloxacin and tetracycline, but had high resistance to ciprofloxacin, clindamycin, and erythromycin. Twenty-three isolates (24.2%) were multidrug-resistant. Conclusions Outpatients with CDI were common during this period in our hospital. The C. difficile isolates had high genetic diversity. All isolates were susceptible to metronidazole and vancomycin, and nearly one quarter of all isolates had multidrug resistance.

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

Frontiers in Microbiology ◽

10.3389/fmicb.2021.756201 ◽

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.

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