Emerging high-risk ST101 and ST307 carbapenem-resistant Klebsiella pneumoniae clones from bloodstream infections in Southern Italy

Autor: Antonio Parisi, Angelica Bianco, Anna Morea, Maria Chironna, Daniela Loconsole, Loredana Capozzi, Anna Lisa De Robertis, Rosanna Mallamaci, Marisa Accogli, Michele Quarto
Rok vydání: 2020
Předmět:
Male
Klebsiella pneumoniae
lcsh:QR1-502
Virulome
Drug resistance
Resistome
lcsh:Microbiology
Medical microbiology
Drug Resistance
Multiple
Bacterial
Prospective Studies
Child
Aged
80 and over
Molecular Epidemiology
0303 health sciences
General Medicine
Middle Aged
ST101
Electrophoresis
Gel
Pulsed-Field
Infectious Diseases
Italy
Child
Preschool
ST307
Female
Adult
Microbiology (medical)
medicine.medical_specialty
Adolescent
Biology
Real-Time Polymerase Chain Reaction
Serogroup
beta-Lactamases
lcsh:Infectious and parasitic diseases
Microbiology
Young Adult
03 medical and health sciences
Bacterial Proteins
medicine
Humans
lcsh:RC109-216
Typing
Genotyping
Aged
030304 developmental biology
Whole genome sequencing
030306 microbiology
Research
lcsh:RM1-950
Infant
Newborn
Infant
biochemical phenomena
metabolism
and nutrition
bacterial infections and mycoses
biology.organism_classification
Klebsiella Infections
lcsh:Therapeutics. Pharmacology
Parasitology
Carbapenem-resistant Klebsiella pneumoniae
Multilocus sequence typing
Bloodstream infections
Multilocus Sequence Typing
Zdroj: Annals of Clinical Microbiology and Antimicrobials, Vol 19, Iss 1, Pp 1-10 (2020)
Annals of Clinical Microbiology and Antimicrobials
ISSN: 1476-0711
Popis: Background Carbapenem-resistant Klebsiella pneumoniae (CR-KP) is an urgent public health issue in Italy. This pattern of resistance is due mainly to dissemination of carbapenemase genes. Molecular characterization of carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains was performed over a three-year period. In-depth analysis was performed on a subset of emerging CR-KP ST101 and ST307 clones. Methods A prospective study was performed on 691 patients with CR-KP bloodstream infections hospitalized in 19 hospitals located in three large provinces in Southern Italy. Carbapenemase genes were identified via genotyping methods. Multi-locus sequence typing (MLST) and Whole Genome Sequencing (WGS) were carried out on ST101 and ST307 isolates. Results Among the CR-KP isolates, blaKPC was found in 95.6%, blaVIM was found in 3.5%, blaNDM was found in 0.1% and blaOXA-48 was found in 0.1%. The blaKPC-3 variant was identified in all 104 characterized KPC-KP isolates. MLST of 231 representative isolates revealed ST512 in 45.5%, ST101 in 20.3% and ST307 in 18.2% of the isolates. cgMLST of ST307 and ST101 isolates revealed presence of more than one beta-lactam resistance gene. Amino acid substitution in the chromosomal colistin-resistance gene pmrB was found in two ST101 isolates. Conclusions ST512 is widespread in Southern Italy, but ST101 and ST307 are emerging since they were found in a significant proportion of cases. Aggressive infection control measures and a continuous monitoring of these high-risk clones are necessary to avoid rapid spread of CR-KP, especially in hospital settings.
Databáze: OpenAIRE
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