| Autor: |
Tsui CK; Infectious Diseases Research Laboratory, National Centre for Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.; Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, Vancouver, Canada.; Weill Cornell Medicine-Qatar, Doha, Qatar., Ben Abid F; Weill Cornell Medicine-Qatar, Doha, Qatar.; Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar.; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar., Al Ismail K; Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar., McElheny CL; Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA., Al Maslamani M; Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar.; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar., Omrani AS; Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar.; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar.; College of Medicine, Qatar University, Doha, Qatar., Doi Y; Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.; Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Japan.; Department of Infectious Diseases, Fujita Health University School of Medicine, Toyoake, Japan. |
| Abstrakt: |
The emergence of carbapenem-resistant, hypervirulent Klebsiella pneumoniae is a new threat to health care. We studied the molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae isolates in Qatar using whole-genome sequence data. We also characterized the prevalence and genetic basis of hypervirulent phenotypes and established the virulence potential using a Galleria mellonella model. Of 100 Klebsiella isolates studied, NDM and OXA-48 were the most common carbapenemases. Core genome single-nucleotide polymorphism (SNP) analysis indicated the presence of diverse sequence types and clonal lineages; isolates belonging to Klebsiella quasipneumoniae subsp. quasipneumoniae sequence type 196 (ST196) and ST1416 may be disseminated among several health care centers. Ten K. pneumoniae isolates carried rmpA and/or truncated rmpA2 , and 2 isolates belonged to KL2, indicating low prevalence of classical hypervirulent isolates. Isolates carrying both carbapenem resistance and hypervirulence genes were confined mainly to ST231 and ST383 isolates. One ST383 isolate was further investigated by MinION sequencing, and the assembled genome indicated that bla NDM was located on an IncHI1B-type plasmid (pFQ61_ST383_NDM-5) which coharbored several virulence factors, including the regulator of the mucoid phenotype ( rmpA ), the regulator of mucoid phenotype 2 ( rmpA2 ), and aerobactin ( iucABCD and iutA ), likely resulting from recombination events. Comparative genomics indicated that this hybrid plasmid may be present in two additional Qatari ST383 isolates. Carbapenem-resistant, hypervirulent K. pneumoniae ST383 isolates pose an emerging threat to global health due to their simultaneous hypervirulence and multidrug resistance. |
