Molecular characterization of colistin resistance genes in a high-risk ST101/KPC-2 clone of Klebsiella pneumoniae in a University Hospital of Split, Croatia.
Colistin resistance
KPC
Klebsiella pneumoniae
ST101
mgrB mutation
Journal
International microbiology : the official journal of the Spanish Society for Microbiology
ISSN: 1618-1905
Titre abrégé: Int Microbiol
Pays: Switzerland
ID NLM: 9816585
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
12
11
2022
accepted:
10
01
2023
revised:
04
01
2023
medline:
3
8
2023
pubmed:
23
1
2023
entrez:
22
1
2023
Statut:
ppublish
Résumé
Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) has become a major concern worldwide due to multidrug resistance and the ability to spread locally and globally. Infections caused by KPC-KP are great challenge in the healthcare systems because these are associated with longer hospitalization and high mortality. The emergence of colistin resistance has significantly reduced already limited treatment options. This study describes the molecular background of colistin-resistant KPC-KP isolates in the largest hospital in southern Croatia. Thirty-four non-duplicate colistin-resistant KPC-KP isolates were collected during routine work from April 2019 to January 2020 and from February to May 2021. Antimicrobial susceptibility was determined using disk diffusion, broth microdilution, and the gradient strip method. Carbapenemase was detected with an immunochromatographic test. Identification of bla
Identifiants
pubmed: 36683114
doi: 10.1007/s10123-023-00327-3
pii: 10.1007/s10123-023-00327-3
pmc: PMC9867991
doi:
Substances chimiques
Colistin
Z67X93HJG1
Anti-Bacterial Agents
0
Bacterial Proteins
0
beta-Lactamases
EC 3.5.2.6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
631-637Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Bassetti M, Righi E, Carnelutti A, Graziano E, Russo A (2018) Multidrug-resistant Klebsiella pneumoniae: challenges for treatment, prevention and infection control. Expert Rev Anti Infect Ther 16(10):749–761. https://doi.org/10.1080/14787210.2018.1522249
doi: 10.1080/14787210.2018.1522249
pubmed: 30207815
Bathoorn E, Tsioutis C, da Silva Voorham JM et al (2016) Emergence of pan-resistance in KPC-2 carbapenemase-producing Klebsiella pneumoniae in Crete, Greece: a close call. J Antimicrob Chemother 71(5):1207–1212. https://doi.org/10.1093/jac/dkv467
doi: 10.1093/jac/dkv467
pubmed: 26817488
Berglund B (2019) Acquired resistance to colistin via chromosomal and plasmid-mediated mechanisms in Klebsiella pneumoniae. Infect Microbes Dis 1(1):10–19. https://doi.org/10.1097/IM9.0000000000000002
doi: 10.1097/IM9.0000000000000002
Can F, Menekse S, Ispir P et al (2018) Impact of the ST101 clone on fatality among patients with colistin-resistant Klebsiella pneumoniae infection. J Antimicrob Chemother 73(5):1235–1241. https://doi.org/10.1093/jac/dkx532
doi: 10.1093/jac/dkx532
pubmed: 29415120
Cannatelli A, D'Andrea MM, Giani T et al (2013) In vivo emergence of colistin resistance in Klebsiella pneumoniae producing KPC-type carbapenemases mediated by insertional inactivation of the PhoQ/PhoP mgrB regulator. Antimicrob Agents Chemother 57(11):5521–5526. https://doi.org/10.1128/AAC.01480-13
doi: 10.1128/AAC.01480-13
pubmed: 23979739
pmcid: 3811314
Cannatelli A, Giani T, D'Andrea MM et al (2014) MgrB inactivation is a common mechanism of colistin resistance in KPC-producing Klebsiella pneumoniae of clinical origin. Antimicrob Agents Chemother 58(10):5696–5703. https://doi.org/10.1128/AAC.03110-14
doi: 10.1128/AAC.03110-14
pubmed: 25022583
pmcid: 4187966
Cannatelli A, Santos-Lopez A, Giani T, Gonzalez-Zorn B, Rossolini GM (2015) Polymyxin resistance caused by mgrB inactivation is not associated with significant biological cost in Klebsiella pneumoniae. Antimicrob Agents Chemother 59(5):2898–2900. https://doi.org/10.1128/AAC.04998-14
doi: 10.1128/AAC.04998-14
pubmed: 25691629
pmcid: 4394794
Cheng YH, Lin TL, Pan YJ, Wang YP, Lin YT, Wang JT (2015) Colistin resistance mechanisms in Klebsiella pneumoniae strains from Taiwan. Antimicrob Agents Chemother 59(5):2909–2913. https://doi.org/10.1128/AAC.04763-14
doi: 10.1128/AAC.04763-14
pubmed: 25691646
pmcid: 4394772
Del Franco M, Paone L, Novati R et al (2015) Molecular epidemiology of carbapenem resistant Enterobacteriaceae in Valle d’Aosta region, Italy, shows the emergence of KPC-2 producing Klebsiella pneumoniae clonal complex 101 (ST101 and ST1789). BMC Microbiol 15(1):260. https://doi.org/10.1186/s12866-015-0597-z
doi: 10.1186/s12866-015-0597-z
pubmed: 26552763
pmcid: 4640108
Di Tella D, Tamburro M, Guerrizio G, Fanelli I, Sammarco ML, Ripabelli G (2019) Molecular epidemiological insights into colistin-resistant and carbapenemases-producing clinical Klebsiella pneumoniae isolates. Infect Drug Resist 12:3783–3795. https://doi.org/10.2147/IDR.S226416
doi: 10.2147/IDR.S226416
pubmed: 31819559
pmcid: 6899070
Esposito EP, Cervoni M, Bernardo M et al (2018) Molecular epidemiology and virulence profiles of colistin-resistant Klebsiella pneumoniae blood isolates from the hospital agency “Ospedale dei Colli,” Naples, Italy. Front Microbiol 9:1463. https://doi.org/10.3389/fmicb.2018.01463
doi: 10.3389/fmicb.2018.01463
pubmed: 30061868
pmcid: 6054975
Giani T, Arena F, Vaggelli G et al (2015) Large nosocomial outbreak of colistin-resistant, carbapenemase-producing Klebsiella pneumoniae traced to clonal expansion of an mgrB deletion mutant. J Clin Microbiol 53(10):3341–3344. https://doi.org/10.1128/JCM.01017-15
doi: 10.1128/JCM.01017-15
pubmed: 26202124
pmcid: 4572530
Giordano C, Barnini S, Tsioutis C et al (2018) Expansion of KPC-producing Klebsiella pneumoniae with various mgrB mutations giving rise to colistin resistance: the role of ISL3 on plasmids. Int J Antimicrob Agents 51(2):260–265. https://doi.org/10.1016/j.ijantimicag.2017.10.011
doi: 10.1016/j.ijantimicag.2017.10.011
pubmed: 29097338
Haeili M, Javani A, Moradi J, Jafari Z, Feizabadi MM, Babaei E (2017) MgrB alterations mediate colistin resistance in Klebsiella pneumoniae isolates from Iran. Front Microbiol 8:2470. https://doi.org/10.3389/fmicb.2017.02470
doi: 10.3389/fmicb.2017.02470
pubmed: 29326662
pmcid: 5741654
Holt KE, Wertheim H, Zadoks RN et al (2015) Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae, an urgent threat to public health. Proc Natl Acad Sci U S A 112(27):E3574–E3581. https://doi.org/10.1073/pnas.1501049112
doi: 10.1073/pnas.1501049112
pubmed: 26100894
pmcid: 4500264
Jelic M, Butic I, Plecko V et al (2015) KPC-producing Klebsiella pneumoniae isolates in Croatia: a nationwide survey. Microb Drug Resist 22(8):662–667. https://doi.org/10.1089/mdr.2015.0150
doi: 10.1089/mdr.2015.0150
pubmed: 26709956
Kanwar A, Marshall SH, Perez F et al (2018) Emergence of resistance to colistin during the treatment of bloodstream infection caused by Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae. Open Forum. Infect Dis 5(4):ofy054. https://doi.org/10.1093/ofid/ofy054
doi: 10.1093/ofid/ofy054
Leung LM, Cooper VS, Rasko DA et al (2017) Structural modification of LPS in colistin-resistant, KPC-producing Klebsiella pneumoniae. J Antimicrob Chemother 72(11):3035–3042. https://doi.org/10.1093/jac/dkx234
doi: 10.1093/jac/dkx234
pubmed: 28961916
pmcid: 5890713
Loconsole D, Accogli M, De Robertis AL et al (2020) Emerging high-risk ST101 and ST307 carbapenem-resistant Klebsiella pneumoniae clones from bloodstream infections in Southern Italy. Ann Clin Microbiol Antimicrob 19(1):24. https://doi.org/10.1186/s12941-020-00366-y
doi: 10.1186/s12941-020-00366-y
pubmed: 32487201
pmcid: 7266126
Nordmann P, Dortet L, Poirel L (2012) Carbapenem resistance in Enterobacteriaceae: here is the storm! Trends Mol Med 18(5):263–272. https://doi.org/10.1016/j.molmed.2012.03.003
doi: 10.1016/j.molmed.2012.03.003
pubmed: 22480775
Olaitan AO, Diene SM, Kempf M et al (2014) Worldwide emergence of colistin resistance in Klebsiella pneumoniae from healthy humans and patients in Lao PDR, Thailand, Israel, Nigeria and France owing to inactivation of the PhoP/PhoQ regulator mgrB: an epidemiological and molecular study. Int J Antimicrob Agents 44(6):500–507. https://doi.org/10.1016/j.ijantimicag.2014.07.020
doi: 10.1016/j.ijantimicag.2014.07.020
pubmed: 25264127
Oteo J, Pérez-Vázquez M, Bautista V et al (2016) The spread of KPC-producing Enterobacteriaceae in Spain: WGS analysis of the emerging high-risk clones of Klebsiella pneumoniae ST11/KPC-2, ST101/KPC-2 and ST512/KPC-3. J Antimicrob Chemother 71(12):3392–3399. https://doi.org/10.1093/jac/dkw321
doi: 10.1093/jac/dkw321
pubmed: 27530752
pmcid: 5890657
Poirel L, Jayol A, Bontron S et al (2015) The mgrB gene as a key target for acquired resistance to colistin in Klebsiella pneumoniae. J Antimicrob Chemother 70(1):75–80. https://doi.org/10.1093/jac/dku323
doi: 10.1093/jac/dku323
pubmed: 25190723
Poirel L, Jayol A, Nordmann P (2017) Polymyxins: antibacterial activity, susceptibility testing, and resistance mechanisms encoded by plasmids or chromosomes. Clin Microbiol Rev 30(2):557–596. https://doi.org/10.1128/CMR.00064-16
doi: 10.1128/CMR.00064-16
pubmed: 28275006
pmcid: 5355641
Ramos-Castañeda JA, Ruano-Ravina A, Barbosa-Lorenzo R et al (2018) Mortality due to KPC carbapenemase-producing Klebsiella pneumoniae infections: systematic review and meta-analysis: mortality due to KPC Klebsiella pneumoniae infections. J Infect 76(5):438–448. https://doi.org/10.1016/j.jinf.2018.02.007
doi: 10.1016/j.jinf.2018.02.007
pubmed: 29477802
Rocha VFD, Barbosa MS, Leal HF et al (2022) Prolonged outbreak of carbapenem and colistin-resistant Klebsiella pneumoniae at a large tertiary hospital in Brazil. Front Microbiol 13:831770. https://doi.org/10.3389/fmicb.2022.831770
doi: 10.3389/fmicb.2022.831770
pubmed: 35356529
pmcid: 8959819
Roe CC, Vazquez AJ, Esposito EP, Zarrilli R, Sahl JW (2019) Diversity, virulence, and antimicrobial resistance in isolates from the newly emerging Klebsiella pneumoniae ST101 lineage. Front Microbiol 10:542. https://doi.org/10.3389/fmicb.2019.00542
doi: 10.3389/fmicb.2019.00542
pubmed: 31001209
pmcid: 6454207
Sisti S, Diotti RA, Caputo V et al (2022) Identification of a novel mutation involved in colistin resistance in Klebsiella pneumoniae through next-generation sequencing (NGS) based approaches. New Microbiol 45(3):199–209
pubmed: 35920875
Xu J, Zhao Z, Ge Y, He F (2020) Rapid emergence of a pandrug-resistant Klebsiella pneumoniae ST11 isolate in an inpatient in a teaching hospital in China after treatment with multiple broad-spectrum antibiotics. Infect Drug Resist 13:799–804. https://doi.org/10.2147/IDR.S243334
doi: 10.2147/IDR.S243334
pubmed: 32210594
pmcid: 7071855
Zowawi HM, Forde BM, Alfaresi M et al (2015) Stepwise evolution of pandrug-resistance in Klebsiella pneumoniae. Sci Rep 5:15082. https://doi.org/10.1038/srep15082
doi: 10.1038/srep15082
pubmed: 26478520
pmcid: 4609946