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Tytuł pozycji:

Clonal transmission of polymyxin B-resistant hypervirulent Klebsiella pneumoniae isolates coharboring bla NDM-1 and bla KPC-2 in a tertiary hospital in China.

Tytuł:
Clonal transmission of polymyxin B-resistant hypervirulent Klebsiella pneumoniae isolates coharboring bla NDM-1 and bla KPC-2 in a tertiary hospital in China.
Autorzy:
Tang M; Department of Clinical Laboratory, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu district, Changsha, Hunan, China.
Li J; Department of Clinical Laboratory, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu district, Changsha, Hunan, China.; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, No.87 Xiangya Road, Kaifu District, Changsha, Hunan, China.
Liu Z; Department of Clinical Laboratory, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu district, Changsha, Hunan, China.
Xia F; Department of Clinical Laboratory, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu district, Changsha, Hunan, China.
Min C; Department of Clinical Laboratory, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu district, Changsha, Hunan, China.
Hu Y; Department of Clinical Laboratory, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu district, Changsha, Hunan, China.; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, No.87 Xiangya Road, Kaifu District, Changsha, Hunan, China.
Wang H; Department of Clinical Laboratory, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu district, Changsha, Hunan, China.; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, No.87 Xiangya Road, Kaifu District, Changsha, Hunan, China.
Zou M; Department of Clinical Laboratory, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu district, Changsha, Hunan, China. .; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, No.87 Xiangya Road, Kaifu District, Changsha, Hunan, China. .
Źródło:
BMC microbiology [BMC Microbiol] 2023 Mar 07; Vol. 23 (1), pp. 64. Date of Electronic Publication: 2023 Mar 07.
Typ publikacji:
Journal Article; Research Support, Non-U.S. Gov't
Język:
English
Imprint Name(s):
Original Publication: London : BioMed Central, [2001-
MeSH Terms:
Klebsiella pneumoniae*/drug effects
Klebsiella pneumoniae*/genetics
Polymyxin B*/pharmacology
Drug Resistance, Multiple, Bacterial*
Klebsiella Infections*/microbiology
Klebsiella Infections*/transmission
Humans ; China/epidemiology ; Tertiary Care Centers ; Disease Outbreaks
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Grant Information:
2021zzts1043 Fundamental Research Funds for the Central Universities of Central South University under Grant; 81702068 National Natural Science Foundation of China; 2020JJ4886 Natural Science Foundation of Hunan Province under Grant; 2022JJ70084 Natural Science Foundation of Hunan Province under Grant; 202111000066 Science Foundation of Hunan Health Commission in Hunan Province under Grant
Contributed Indexing:
Keywords: Clonal transmission; Hypervirulence; Klebsiella pneumoniae; Polymyxin B; ST11-K64; Whole-genome sequencing
Substance Nomenclature:
EC 3.5.2.6 (beta-lactamase NDM-1)
J2VZ07J96K (Polymyxin B)
Entry Date(s):
Date Created: 20230307 Date Completed: 20230309 Latest Revision: 20230313
Update Code:
20240104
PubMed Central ID:
PMC9990273
DOI:
10.1186/s12866-023-02808-x
PMID:
36882683
Czasopismo naukowe
Background: The prevalence of multidrug-resistant hypervirulent K. pneumoniae (MDR-hvKP) has gradually increased. It poses a severe threat to human health. However, polymyxin-resistant hvKP is rare. Here, we collected eight polymyxin B-resistant K. pneumoniae isolates from a Chinese teaching hospital as a suspected outbreak.
Results: The minimum inhibitory concentrations (MICs) were determined by the broth microdilution method. HvKP was identified by detecting virulence-related genes and using a Galleria mellonella infection model. Their resistance to serum, growth, biofilm formation, and plasmid conjugation were analyzed in this study. Molecular characteristics were analyzed using whole-genome sequencing (WGS) and mutations of chromosome-mediated two-component systems pmrAB and phoPQ, and the negative phoPQ regulator mgrB to cause polymyxin B (PB) resistance were screened. All isolates were resistant to polymyxin B and sensitive to tigecycline; four were resistant to ceftazidime/avibactam. Except for KP16 (a newly discovered ST5254), all were of the K64 capsular serotype and belonged to ST11. Four strains co-harbored bla KPC-2 , bla NDM-1 , and the virulence-related genes p rmpA, p rmpA2, iucA, and peg344, and were confirmed to be hypervirulent by the G. mellonella infection model. According to WGS analysis, three hvKP strains showed evidence of clonal transmission (8-20 single nucleotide polymorphisms) and had a highly transferable pKOX_NDM1-like plasmid. KP25 had multiple plasmids carrying bla KPC-2 , bla NDM-1 , bla SHV-12 , bla LAP-2 , tet(A), fosA5, and a pLVPK-like virulence plasmid. Tn1722 and multiple additional insert sequence-mediated transpositions were observed. Mutations in chromosomal genes phoQ and pmrB, and insertion mutations in mgrB were major causes of PB resistance.
Conclusions: Polymyxin-resistant hvKP has become an essential new superbug prevalent in China, posing a serious challenge to public health. Its epidemic transmission characteristics and mechanisms of resistance and virulence deserve attention.
(© 2023. The Author(s).)
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