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Kimseng H, Rossi G, Danjean M, Jimenez-Araya B, Chaligne C, Galy A, Souhail B, Bert F, Leflon V, Fihman V, Caillault A, Demontant V, Seng S, Trawinski E, N 'Debi M, Boizeau L, Jacquier H, Ronot M, Reizine E, Le Roy V, Lefort A, Rodriguez C, Lepeule R, Woerther PL. Evaluation of the contribution of shotgun metagenomics in the microbiological diagnosis of liver abscesses. J Infect 2023; 87:365-372. [PMID: 37604210 DOI: 10.1016/j.jinf.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Shotgun metagenomics (SMg) sequencing has gained a considerable interest, as it enables the detection of any microorganisms through a single analysis. Due to the limitations of standard microbiological approaches, the microbial documentation of liver abscesses (LA), which is crucial for their medical management, can be difficult. Here we aimed to compare the performance of SMg with standard approaches for the microbiological documentation of LA. METHODS In this retrospective study conducted at two centers, we compared the results of standard microbiology with metagenomics analysis of consecutive LA samples. For samples tested positive for Klebsiella pneumoniae, we compared the analysis of virulence and resistance genes using metagenomics data to whole-genome sequencing of corresponding isolates obtained in culture. RESULTS Out of the 62 samples included, standard approaches and SMg yielded documentation in 80.6% and 96.8%, respectively. In 37.1% (23/62) of cases, both methods showed identical results, whereas in 43.5% (27/62) of cases, the samples were positive by both methods, but SMg found additional species in 88.9% (24/27), mostly anaerobes. When the standard approaches were negative, the SMg was able to detect microorganisms in 80.0% of cases (8/10). Overall, SMg identified significantly more microorganisms than culture (414 vs.105; p<0.05). K. pneumoniae genome analysis was able to detect resistance and virulence genes with a level of sensitivity depending on the depth of sequencing. DISCUSSION Overall, we showed that SMg had better performance in detecting and identifying microorganisms from LA samples and could help characterizing strain's resistome and virulome. Although still costly and requiring specific skills and expensive equipment, MGs methods are set to expand in the future.
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Affiliation(s)
- Hadrien Kimseng
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France
| | - Geoffrey Rossi
- Department of Internal Medicine, Beaujon Hospital, GHU AP-HP Nord-Université Paris Cité, Clichy, France
| | - Maxime Danjean
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France
| | - Bryan Jimenez-Araya
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France
| | - Camille Chaligne
- Department of Internal Medicine, Beaujon Hospital, GHU AP-HP Nord-Université Paris Cité, Clichy, France
| | - Adrien Galy
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France; Antimicrobial Stewardship Team, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France
| | - Bérénice Souhail
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France; Antimicrobial Stewardship Team, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France
| | - Frédéric Bert
- Department of Microbiology, Beaujon Hospital, GHU AP-HP Nord-Université Paris Cité, Clichy, France
| | - Véronique Leflon
- Department of Microbiology, Beaujon Hospital, GHU AP-HP Nord-Université Paris Cité, Clichy, France
| | - Vincent Fihman
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France
| | | | | | - Sarah Seng
- NGS Platform, IMRB Institute, Créteil, France
| | | | | | | | - Hervé Jacquier
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France
| | - Maxime Ronot
- Department of Radiology, Beaujon Hospital, GHU AP-HP Nord-Université Paris Cité, Clichy, France
| | - Edouard Reizine
- Department of Radiology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Vincent Le Roy
- Department of Hepatology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Agnès Lefort
- Department of Internal Medicine, Beaujon Hospital, GHU AP-HP Nord-Université Paris Cité, Clichy, France; IAME, UMR1137, Université Paris-Cité, Paris, France
| | - Christophe Rodriguez
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; INSERM U955, IMRB Institute, Créteil, France; NGS Platform, IMRB Institute, Créteil, France
| | - Raphaël Lepeule
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France; Antimicrobial Stewardship Team, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France
| | - Paul-Louis Woerther
- Department of Microbiology, Henri Mondor Hospital, AP-HP, University of Paris-Est, Créteil, France; EA 7380 Dynamyc, EnvA, UPEC, University of Paris-Est, Créteil, France; NGS Platform, IMRB Institute, Créteil, France.
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Sohrabi M, Alizade Naini M, Rasekhi A, Oloomi M, Moradhaseli F, Ayoub A, Bazargani A, Hashemizadeh Z, Shahcheraghi F, Badmasti F. Emergence of K1 ST23 and K2 ST65 hypervirulent klebsiella pneumoniae as true pathogens with specific virulence genes in cryptogenic pyogenic liver abscesses Shiraz Iran. Front Cell Infect Microbiol 2022; 12:964290. [PMID: 36017366 PMCID: PMC9396702 DOI: 10.3389/fcimb.2022.964290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
Hypervirulent Klebsiella pneumoniae (hvKp) pathotype is emerging worldwide in pyogenic liver abscesses (PLAs). However, the role of virulence factors in pathogenicity remains unclear. On the other hand, the epidemiology of PLAs in Iran is unknown. From July 2020 to April 2022, bacterial species were isolated and identified from the drainage samples of 54 patients with PLAs. K. pneumoniae as the most common pathogen of pyogenic liver abscesses was identified in 20 (37%) of the 54 patients. We analyzed the clinical and microbiological characteristics of K. pneumoniae-related pyogenic liver abscesses. Antibiotic susceptibility testes and string test were performed. 16S rRNA, antibiotic resistance, and virulence genes were determined by polymerase chain reaction amplification. Clonal relatedness of isolates was identified by multilocus sequence typing. Virulence levels were assessed in the Galleria mellonella larval infection model. Four hvKp isolates (K1/K2) were found to be responsible for cryptogenic PLAs, and 16 classical K. pneumoniae isolates (non-K1/K2) were associated with non-cryptogenic PLAs. Three capsular serotype K1 strains belonged to sequence type 23 (ST23) and one K2 strain to ST65. Meanwhile, the non-K1/K2 strains belonged to other STs. ST231 was the most common strain among the classical K. pneumoniae strains. Compared with the non-K1/K2 strains, capsular serotypes K1/K2 strains were less resistant to antibiotics, had positive string test results, and had more virulence genes. In Galleria mellonella, a concentration of 106 colony-forming units of the K1 hvKp strain resulted in 100% death at 24 hours, confirming the higher virulence of the hvKp strain compared with cKp. K. pneumoniae isolates represented that the acquisition of any plasmid or chromosomal virulence genes contributes to pathogenicity and high prevalence in PLAs. Meanwhile, hvKp isolates with a specific genetic background were detected in cryptogenic PLAs.
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Affiliation(s)
- Maryam Sohrabi
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Mahvash Alizade Naini
- Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Rasekhi
- Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mana Oloomi
- Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
| | - Farzad Moradhaseli
- Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Ayoub
- Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdollah Bazargani
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Hashemizadeh
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fereshteh Shahcheraghi
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
- *Correspondence: Farzad Badmasti, ; Fereshteh Shahcheraghi,
| | - Farzad Badmasti
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
- *Correspondence: Farzad Badmasti, ; Fereshteh Shahcheraghi,
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