The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla NDM/OXA-48 carbapenemases in a tertiary care center of Iran

Autor: Ali Ebrahimi, Zakaria Bameri, Zoya Hojabri, Narges Darabi, Raheb Ghorbani, Omid Pajand, Maedeh Arab
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Klebsiella pneumoniae
lcsh:QR1-502
Drug resistance
Iran
Polymerase Chain Reaction
lcsh:Microbiology
Tertiary Care Centers
Medical microbiology
rmtC
Siderophore
Drug Resistance
Multiple
Bacterial
Genotype
Blood culture
Phylogeny
OXA-48
Capsular type
0303 health sciences
medicine.diagnostic_test
biology
Virulence
General Medicine
Infectious Diseases
Phylogroup
Amikacin
Epidemiological Monitoring
medicine.drug
Microbiology (medical)
medicine.medical_specialty
Microbial Sensitivity Tests
NDM
beta-Lactamases
Microbiology
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Bacterial Proteins
medicine
Humans
lcsh:RC109-216
Bacterial Capsules
030304 developmental biology
hvKp
030306 microbiology
Research
lcsh:RM1-950
biochemical phenomena
metabolism
and nutrition
biology.organism_classification
DNA Fingerprinting
Klebsiella Infections
Multiple drug resistance
lcsh:Therapeutics. Pharmacology
Carbapenems
Zdroj: Annals of Clinical Microbiology and Antimicrobials, Vol 19, Iss 1, Pp 1-9 (2020)
Annals of Clinical Microbiology and Antimicrobials
ISSN: 1476-0711
DOI: 10.1186/s12941-020-00349-z
Popis: Background Klebsiella pneumoniae is a public health concern because of its ability to develop multidrug resistance and hypervirulent genotypes, of those capsular types K1 and K2 cause community and nosocomial life-threatening infections. This study aimed to determine the antibiotic susceptibility patterns and genotypic traits of a collection of Klebsiella spp. isolates. Furthermore, the clonal relatedness of blaNDM producing strains was investigated. Methods During a 19-months surveillance study, 122 Klebsiella spp. isolates were cultured from extraintestinal specimens of patients admitted to the tertiary referral hospital in Semnan, Iran. Isolates were identified using biochemical tests and subjected to determination of phylogroups, capsular types and virulence/resistance genes content. Hypervirulent K. pneumoniae (hvKp) strains were detected genotypically, and Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR fingerprinting was used to determine the clonality of blaNDM producing strains. Results Multidrug resistant phenotype was detected in 75 (61.5%) isolates and amikacin was found as the most potent antibiotic with the susceptibility rate of 85.2%. The carbapenemase genes were detected in 45 (36.8%) strains, including 21 (17.2%) blaOXA-48, 7 (5.6%) blaNDM-1, 14 (11.4%) blaNDM-1/OXA-48 and 3 (2.4%) blaIMP- carrying strains, while 55 (45.08%) isolates showed carbapenem resistant phenotype. The first blaNDM-1 carrying strain was cultured from a sputum specimen on March 2015, while the last positive one was recovered from blood culture on September 2016. Most of the isolates (80.3%) belonged to phylogroup I, and blaNDM-1 was identified among all three phylogroups. The ERIC-PCR clustered the 101 blaNDM negative and 21 blaNDM-1 positive isolates into 25 and five clusters, respectively, and the latter group belonged to clonal complex 147 (CC147). One K1 and 15 K2 blaNDM-1 negative isolates were detected, of those three strains were identified as hvKp. Five K2 positive strains, including four blaOXA-48 producer and one hvKp sequence type 86 (ST86) were carbapenem resistant. Among carbapenem resistant isolates, CC147 strains harboured higher rates of siderophores iutA and ybtS. Conclusion The present findings showed a hospital circulation of CC147 blaNDM-1 or blaNDM-1/OXA-48 producing strains, disseminated in different wards. The hvKp/ST86 strain expressing K2 capsular type and carbapenem resistant phenotype wasn’t reported from Iran so far. So, it seems that we must be aware of the emergence and spread of new K. pneumoniae clones associated with resistant and hypermucoviscous phenotypes.
Databáze: OpenAIRE
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