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Convergence of carbapenem resistance and hypervirulence in a highly-transmissible ST11 clone of K. pneumoniae: An epidemiological, genomic and functional study.
Li, Ping; Liang, Qiqiang; Liu, Wugao; Zheng, Beiwen; Liu, Lizhang; Wang, Wei; Xu, Zhijiang; Huang, Man; Feng, Youjun.
Afiliação
  • Li P; Department of Pathogen Biology & Microbiology and Department of General Intensive Care Unit of the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang China.
  • Liang Q; Department of Pathogen Biology & Microbiology and Department of General Intensive Care Unit of the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang China.
  • Liu W; Clinical Laboratory of Lishui People's Hospital , Lishui, China.
  • Zheng B; The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, China.
  • Liu L; Department of Pathogen Biology & Microbiology and Department of General Intensive Care Unit of the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang China.
  • Wang W; Clinical Laboratory of Lishui People's Hospital , Lishui, China.
  • Xu Z; Clinical Laboratory, the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, China.
  • Huang M; Department of Pathogen Biology & Microbiology and Department of General Intensive Care Unit of the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang China.
  • Feng Y; Department of Pathogen Biology & Microbiology and Department of General Intensive Care Unit of the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang China.
Virulence ; 12(1): 377-388, 2021 12.
Article em En | MEDLINE | ID: mdl-33356821
Co-occurrence of hypervirulence and KPC-2 carbapenem resistant phenotypes in a highly-transmissible ST11 clone ofKlebsiella pneumoniae has elicited deep concerns from public health stand point. To address this puzzle, we conducted a large-scale epidemiological, clinical and genomic study of K. pneumonia ST11 clones with both hypervirulence and carbapenem resistance in two tertiary hospitals in Zhejiang province. Most of the patients (15/23) were diagnosed with exclusively carbapenem-resistant K. pneumoniae (CRKP) infections. Ten death cases were reported, some of which are due to the failure of antibiotic therapies. As a result, we identified one new rare sequence types (ST449) to KPC-2-producing CRKP, in addition to the dominant ST11. These clinical isolates of K. pneumoniae are multi-drug resistant and possess a number of virulence factors. Experimental infections of wax moth larvae revealed the presence of hypervirulence at varied level, suggesting the complexity in bacterial virulence factors. However, plasmid curing assays further suggested that the rmpA2-virulence plasmid is associated with, but not sufficient for neither phenotypic hypermucoviscosity nor virulence of K. pneumoniae. Intriguingly, all the rmpA2 genes were found to be inactive due to genetic deletion. In total, we reported 21 complete plasmid sequences comprising 13 rmpA2-positive virulence plasmids and 8 blaKPC-2-harboring resistance plasmids. In addition to the prevalent pLVKP-like virulence plasmid variants (~178kb), we found an unexpected diversity among KPC-2-producing plasmids whose dominant form is IncFII-IncR type (~120kb), rather than the previously anticipated version of ~170kb. These findings provide an updated snapshot of convergence of hypervirulence and carbapenem resistance in ST11 K. pneumoniae.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 3_ND Base de dados: MEDLINE Assunto principal: Proteínas de Bactérias / Infecções por Klebsiella / Carbapenêmicos / Genômica / Klebsiella pneumoniae / Antibacterianos Tipo de estudo: Prognostic_studies Limite: Adolescent / Adult / Aged / Aged80 / Animals / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: Virulence Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 3_ND Base de dados: MEDLINE Assunto principal: Proteínas de Bactérias / Infecções por Klebsiella / Carbapenêmicos / Genômica / Klebsiella pneumoniae / Antibacterianos Tipo de estudo: Prognostic_studies Limite: Adolescent / Adult / Aged / Aged80 / Animals / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: Virulence Ano de publicação: 2021 Tipo de documento: Article