Emergence of an XDR and carbapenemase-producing hypervirulent Klebsiella pneumoniae strain in Taiwan
| Autor: | Yen Hua Huang, Chung En Ni, Tsuey Ching Yang, Sheng Hua Chou, Syun Wun Liang, Yi Tsung Lin, Yi Wei Huang |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Genotype Klebsiella pneumoniae 030106 microbiology Taiwan Virulence Tigecycline Drug resistance Biology Polymorphism Single Nucleotide beta-Lactamases Microbiology Mice 03 medical and health sciences Bacterial Proteins Drug Resistance Multiple Bacterial medicine Pulsed-field gel electrophoresis Animals Humans Pharmacology (medical) Phylogeny Aged 80 and over Pharmacology Colistin biochemical phenomena metabolism and nutrition bacterial infections and mycoses biology.organism_classification Anti-Bacterial Agents Klebsiella Infections Mice Inbred C57BL Carbapenem-Resistant Enterobacteriaceae Infectious Diseases Carbapenems Multilocus sequence typing Female Multilocus Sequence Typing Plasmids medicine.drug |
| Zdroj: | Journal of Antimicrobial Chemotherapy. 73:2039-2046 |
| ISSN: | 1460-2091 0305-7453 |
| DOI: | 10.1093/jac/dky164 |
| Popis: | Background Carbapenemase-producing Klebsiella pneumoniae causes high mortality owing to the limited therapeutic options available. Here, we investigated an emergent carbapenem-resistant K. pneumoniae strain with hypervirulence found among KPC-2-producing strains in Taiwan. Methods KPC-producing K. pneumoniae strains were collected consecutively from clinical specimens at the Taipei Veterans General Hospital between January 2012 and December 2014. Capsular types and the presence of rmpA/rmpA2 were analysed, and PFGE and MLST performed using these strains. The strain positive for rmpA/rmpA2 was tested in an in vivo mouse lethality study to verify its virulence and subjected to WGS to delineate its genomic features. Results A total of 62 KPC-2-producing K. pneumoniae strains were identified; all of these belonged to ST11 and capsular genotype K47. One strain isolated from a fatal case with intra-abdominal abscess (TVGHCRE225) harboured rmpA and rmpA2 genes. This strain was resistant to tigecycline and colistin, in addition to carbapenems, and did not belong to the major cluster in PFGE. TVGHCRE225 exhibited high in vivo virulence in the mouse lethality experiment. WGS showed that TVGHCRE225 acquired a novel hybrid virulence plasmid harbouring a set of virulence genes (iroBCDN, iucABCD, rmpA and rmpA2, and iutA) compared with the classic ST11 KPC-2-producing strain. Conclusions We identified an XDR ST11 KPC-2-producing K. pneumoniae strain carrying a hybrid virulent plasmid in Taiwan. Active surveillance focusing on carbapenem-resistant hypervirulent K. pneumoniae strains is necessary, as the threat to human health is imminent. |
| Databáze: | OpenAIRE |
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