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Tu Y, Gao H, Zhao R, Yan J, Wu D. Analysis of the Association Between Antimicrobial Resistance Genes and Virulence Factors in ST11 and Non-ST11 CR-KP Bloodstream Infections in the Intensive Care Unit. Infect Drug Resist 2024; 17:4011-4022. [PMID: 39309066 PMCID: PMC11415610 DOI: 10.2147/idr.s478156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 09/12/2024] [Indexed: 09/25/2024] Open
Abstract
Objective This study aims to investigate the association between antimicrobial resistance genes and virulence factors in ST11 and non-ST11 types of CR-KP in bloodstream infections in the intensive care unit, providing a theoretical basis for infection control and clinical diagnosis and treatment. Methods From January 2021 to June 2023, samples of Klebsiella pneumoniae from bloodstream infections were collected at our hospital, focusing on those resistant to carbapenems. The resistance genes, housekeeping genes, and virulence genes were identified through PCR and analyzed using the GrapeTree software to perform MLST-based minimum spanning tree typing. Results Among the 85 CR-KP cases, 61.18% were of the ST11 type, predominantly of the KL64 capsular type; non-ST11 types were mainly ST15, accounting for 25.88%, predominantly of the KL5 capsular type. The carriage rates of virulence genes such as rmpA2, entB, silS, kpn, iucA, peg-344, and terB were significantly higher in the ST11 group than in the non-ST11 group. The primary carbapenemase identified was class A enzyme bla KPC-2, with a higher carriage rate in the ST11 group. Drug susceptibility tests showed that the resistance rates for cefepime, ertapenem, nitrofurantoin, amikacin, and gentamicin were also higher in the ST11 group, consistent with the resistance genotype findings. Conclusion The study reveals that ST11 type CR-KP in intensive care unit bloodstream infections exhibits stronger resistance and higher virulence compared to non-ST11 types, posing significant challenges to clinical treatment. Thus, strict control over the use of carbapenem antibiotics is essential to prevent the spread of resistant plasmids.
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Affiliation(s)
- Yanye Tu
- Clinical Laboratory of Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang Province, People’s Republic of China
| | - Hui Gao
- Clinical Laboratory of Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang Province, People’s Republic of China
| | - Rongqing Zhao
- Clinical Laboratory of Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang Province, People’s Republic of China
| | - Jiliang Yan
- Clinical Laboratory of Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang Province, People’s Republic of China
| | - Diyu Wu
- School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People’s Republic of China
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Li J, Yu L, Wang R, Lan J, Li M, Qiao Y, Tao Z, Lü H, Wang F, Fang Q, Guo P. The role of silver nanoparticles alone and combined with imipenem on carbapenem-resistant Klebsiella pneumoniae. J Appl Microbiol 2024; 135:lxae077. [PMID: 38544327 DOI: 10.1093/jambio/lxae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/11/2024] [Accepted: 03/26/2024] [Indexed: 05/07/2024]
Abstract
AIMS Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections poses a significant threat to human health, necessitating urgent development of new antimicrobial agents. Silver nanoparticles (AgNPs), which are among the most widely used engineered nanomaterials, have been extensively studied. However, the impact of AgNPs on CRKP and the potential for drug resistance development remain inadequately explored. METHODS AND RESULTS In this study, broth dilution method was used to determine the minimum inhibitory concentration (MIC) was determined using the broth dilution method. Results indicated MIC values of 93.1 ± 193.3 µg ml-1 for AgNPs, 2.3 ± 5.1 µg ml-1 for AgNO3, and 25.1 ± 48.3 µg ml-1 for imipenem (IMI). The combined inhibitory effect of AgNPs and IMI on CRKP was assessed using the checkerboard method. Moreover, after 6-20 generations of continuous culture, the MIC value of AgNPs increased 2-fold. Compared to IMI, resistance of Kl. pneumoniae to AgNPs developed more slowly, with a higher fold increase in MIC observed after 20 generations. Whole-genome sequencing revealed four nonsynonymous single nucleotide polymorphism mutations in CRKP after 20 generations of AgNP treatment. CONCLUSION We have demonstrated that AgNPs significantly inhibit CRKP isolates and enhance the antibacterial activity of imipenem against Kl. pneumoniae. Although the development of AgNP resistance is gradual, continued efforts are necessary for monitoring and studying the mechanisms of AgNP resistance.
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Affiliation(s)
- Jiangyan Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical University, Changhuai Road 287, Bengbu, Anhui Province 233030, China
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Changhuai Road 287, Bengbu, Anhui Province 233030, China
| | - Lian Yu
- Bengbu Medical University, Donghaidadao 2600, Bengbu, Anhui Province 233030, China
| | - Ruirui Wang
- Bengbu Medical University, Donghaidadao 2600, Bengbu, Anhui Province 233030, China
| | - Jiaqi Lan
- Bengbu Medical University, Donghaidadao 2600, Bengbu, Anhui Province 233030, China
| | - Ming Li
- Bengbu Medical University, Donghaidadao 2600, Bengbu, Anhui Province 233030, China
| | - Yan Qiao
- Department of Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical University, Changhuai Road 287, Bengbu, Anhui Province 233030, China
| | - Zhaoyu Tao
- Bengbu Medical University, Donghaidadao 2600, Bengbu, Anhui Province 233030, China
| | - Hezuo Lü
- Department of Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical University, Changhuai Road 287, Bengbu, Anhui Province 233030, China
| | - Fengchao Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical University, Changhuai Road 287, Bengbu, Anhui Province 233030, China
| | - Qiang Fang
- Bengbu Medical University, Donghaidadao 2600, Bengbu, Anhui Province 233030, China
| | - Pu Guo
- Department of Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical University, Changhuai Road 287, Bengbu, Anhui Province 233030, China
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Salas-Orozco MF, Lorenzo-Leal AC, de Alba Montero I, Marín NP, Santana MAC, Bach H. Mechanism of escape from the antibacterial activity of metal-based nanoparticles in clinically relevant bacteria: A systematic review. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2024; 55:102715. [PMID: 37907198 DOI: 10.1016/j.nano.2023.102715] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/05/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023]
Abstract
The emergency of antibiotic-resistant bacteria in severe infections is increasing, especially in nosocomial environments. The ESKAPE group is of special importance in the groups of multi-resistant bacteria due to its high capacity to generate resistance to antibiotics and bactericides. Therefore, metal-based nanomaterials are an attractive alternative to combat them because they have been demonstrated to damage biomolecules in the bacterial cells. However, there is a concern about bacteria developing resistance to NPs and their harmful effects due to environmental accumulation. Therefore, this systematic review aims to report the clinically relevant bacteria that have developed resistance to the NPs. According to the results of this systematic review, various mechanisms to counteract the antimicrobial activity of various NP types have been proposed. These mechanisms can be grouped into the following categories: production of extracellular compounds, metal efflux pumps, ROS response, genetic changes, DNA repair, adaptative morphogenesis, and changes in the plasma membrane.
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Affiliation(s)
- Marco Felipe Salas-Orozco
- Facultad de Estomatología, Doctorado en Ciencias Odontológicas, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico.
| | - Ana Cecilia Lorenzo-Leal
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Nuria Patiño Marín
- Facultad de Estomatología, Laboratorio de Investigación Clinica, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Miguel Angel Casillas Santana
- Maestría en Estomatología con Opcion Terminal en Ortodoncia, Facultad de Estomatología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Horacio Bach
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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4
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Lithgo RM, Hanževački M, Harris G, Kamps JJAG, Holden E, Gianga TM, Benesch JLP, Jäger CM, Croft AK, Hussain R, Hobman JL, Orville AM, Quigley A, Carr SB, Scott DJ. The adaptability of the ion-binding site by the Ag(I)/Cu(I) periplasmic chaperone SilF. J Biol Chem 2023; 299:105331. [PMID: 37820867 PMCID: PMC10656224 DOI: 10.1016/j.jbc.2023.105331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/30/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023] Open
Abstract
The periplasmic chaperone SilF has been identified as part of an Ag(I) detoxification system in Gram-negative bacteria. Sil proteins also bind Cu(I) but with reported weaker affinity, therefore leading to the designation of a specific detoxification system for Ag(I). Using isothermal titration calorimetry, we show that binding of both ions is not only tighter than previously thought but of very similar affinities. We investigated the structural origins of ion binding using molecular dynamics and QM/MM simulations underpinned by structural and biophysical experiments. The results of this analysis showed that the binding site adapts to accommodate either ion, with key interactions with the solvent in the case of Cu(I). The implications of this are that Gram-negative bacteria do not appear to have evolved a specific Ag(I) efflux system but take advantage of the existing Cu(I) detoxification system. Therefore, there are consequences for how we define a particular metal resistance mechanism and understand its evolution in the environment.
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Affiliation(s)
- Ryan M Lithgo
- School of Biosciences, Sutton Bonington Campus, University of Nottingham, Leicestershire, United Kingdom; Membrane Protein Laboratory, Diamond Light Source, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom; Diamond Light Source, Diamond House, Rutherford Appleton Laboratories, Didcot, Oxfordshire, United Kingdom; Research Complex at Harwell, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom
| | - Marko Hanževački
- Department of Chemical and Environmental Engineering, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Gemma Harris
- Research Complex at Harwell, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom
| | - Jos J A G Kamps
- Diamond Light Source, Diamond House, Rutherford Appleton Laboratories, Didcot, Oxfordshire, United Kingdom; Research Complex at Harwell, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom
| | - Ellie Holden
- Department of Chemistry, University of Oxford, Oxford, Oxfordshire, United Kingdom
| | - Tiberiu-Marius Gianga
- Diamond Light Source, Diamond House, Rutherford Appleton Laboratories, Didcot, Oxfordshire, United Kingdom
| | - Justin L P Benesch
- Department of Chemistry, University of Oxford, Oxford, Oxfordshire, United Kingdom
| | - Christof M Jäger
- Department of Chemical and Environmental Engineering, University of Nottingham, University Park, Nottingham, United Kingdom; Department of Data Science and Modelling, Pharmaceutical Sciences, R&D, AstraZeneca Gothenburg, Mölndal, Sweden
| | - Anna K Croft
- Department of Chemical Engineering, University of Loughborough, Loughborough, United Kingdom
| | - Rohannah Hussain
- Diamond Light Source, Diamond House, Rutherford Appleton Laboratories, Didcot, Oxfordshire, United Kingdom
| | - Jon L Hobman
- School of Biosciences, Sutton Bonington Campus, University of Nottingham, Leicestershire, United Kingdom
| | - Allen M Orville
- Diamond Light Source, Diamond House, Rutherford Appleton Laboratories, Didcot, Oxfordshire, United Kingdom; Research Complex at Harwell, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom
| | - Andrew Quigley
- Membrane Protein Laboratory, Diamond Light Source, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom; Diamond Light Source, Diamond House, Rutherford Appleton Laboratories, Didcot, Oxfordshire, United Kingdom; Research Complex at Harwell, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom
| | - Stephen B Carr
- Research Complex at Harwell, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom; Department of Chemistry, University of Oxford, Oxford, Oxfordshire, United Kingdom
| | - David J Scott
- School of Biosciences, Sutton Bonington Campus, University of Nottingham, Leicestershire, United Kingdom; Research Complex at Harwell, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom.
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5
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Li L, Ma J, Cheng P, Li M, Yu Z, Song X, Yu Z, Sun H, Zhang W, Wang Z. Roles of two-component regulatory systems in Klebsiella pneumoniae: Regulation of virulence, antibiotic resistance, and stress responses. Microbiol Res 2023; 272:127374. [PMID: 37031567 DOI: 10.1016/j.micres.2023.127374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/09/2023]
Abstract
Klebsiella pneumoniae is an opportunistic pathogen belonging to the Enterobacteriaceae family, which is the leading cause of nosocomial infections. The emergence of hypervirulent and multi-drug resistant K. pneumoniae is a serious health threat. In the process of infection, K. pneumoniae needs to adapt to different environmental conditions, and the two-component regulatory system (TCS) composed of a sensor histidine kinase and response regulator is an important bacterial regulatory system in response to external stimuli. Understanding how K. pneumoniae perceives and responds to complex environmental stimuli provides insights into TCS regulation mechanisms and new targets for drug design. In this review, we analyzed the TCS composition and summarized the regulation mechanisms of TCSs, focusing on the regulation of genes involved in virulence, antibiotic resistance, and stress response. Collectively, these studies demonstrated that several TCSs play important roles in the regulation of virulence, antibiotic resistance and stress responses of K. pneumoniae. A single two-component regulatory system can participate in the regulation of several stress responses, and one stress response process may include several TCSs, forming a complex regulatory network. However, the function and regulation mechanism of some TCSs require further study. Hence, future research endeavors are required to enhance the understanding of TCS regulatory mechanisms and networks in K. pneumoniae, which is essential for the design of novel drugs targeting TCSs.
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Safain KS, Islam MS, Amatullah J, Mahmud-Un-Nabi MA, Bhuyan GS, Rahman J, Sarker SK, Islam MT, Sultana R, Qadri F, Mannoor K. Prevalence of silver resistance determinants and extended-spectrum β-lactamases in bacterial species causing wound infection: First report from Bangladesh. New Microbes New Infect 2023; 52:101104. [PMID: 36915390 PMCID: PMC10006487 DOI: 10.1016/j.nmni.2023.101104] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Background The use of silver is rapidly rising in wound care and silver-containing dressings are widely used along with other antibiotics, particularly β-lactams. Consequently, concerns are being raised regarding the emergence of silver-resistance and cross-resistance to β-lactams. Therefore, this study aimed to determine the phenotypic and genotypic profiles of silver-resistance and extended-spectrum β-lactamases in isolates from chronic wounds. Methods 317 wound swab specimens were collected from tertiary hospitals of Dhaka city and analysed for the microbial identification. The antibiotic resistance/susceptibility profiles were determined and phenotypes of silver resistant isolates were examined. The presence of silver-resistance (sil) genes (silE, silP, and silS) and extended-spectrum β-lactamases (ESBL) (CTX-M-1, NDM-1, KPC, OXA-48, and VIM-1) were explored in isolated microorganisms. Results A total of 501 strains were isolated with Staphylococcus aureus (24%) as the predominant organism. In 29% of the samples, polymicrobial infections were observed. A large proportion of Enterobacterales (59%) was resistant to carbapenems and a significantly high multiple antibiotic-resistance indexes (>0.2) were seen for 53% of organisms (P < 0.001). According to molecular analysis, the most prevalent types of ESBL and sil gene were CTX-M-1 (47%) and silE (42%), respectively. Furthermore, phenotypic silver-nitrate susceptibility testing showed significant minimum-inhibitory-concentration patterns between sil-negative and sil-positive isolates. We further observed co-occurrence of silver-resistance determinants and ESBLs (65%). Conclusions Notably, this is the first-time detection of silver-resistance along with its co-detection with ESBLs in Bangladesh. This research highlights the need for selecting appropriate treatment strategies and developing new alternative therapies to minimize microbial infection in wounds.
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Affiliation(s)
- Kazi Sarjana Safain
- Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.,Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Mohammad Sazzadul Islam
- Genetics and Genomics Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.,Department of Biochemistry and Molecular Biology, Jagannath University, Dhaka, Bangladesh
| | - Jumanah Amatullah
- Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.,Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Mohammad Al Mahmud-Un-Nabi
- Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh
| | - Golam Sarower Bhuyan
- Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh
| | - Jakia Rahman
- Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.,Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Suprovath Kumar Sarker
- Genetics and Genomics Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh
| | - Md Tarikul Islam
- Genetics and Genomics Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh
| | - Rosy Sultana
- Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.,Department of Immunology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Firdausi Qadri
- Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.,Genetics and Genomics Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.,Department of Enteric and Respiratory Infectious Diseases, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Kaiissar Mannoor
- Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.,Genetics and Genomics Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh
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Wand ME, Sutton JM. Efflux-mediated tolerance to cationic biocides, a cause for concern? MICROBIOLOGY (READING, ENGLAND) 2022; 168. [PMID: 36748532 DOI: 10.1099/mic.0.001263] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
AbstractWith an increase in the number of isolates resistant to multiple antibiotics, infection control has become increasingly important to help combat the spread of multi-drug-resistant pathogens. An important component of this is through the use of disinfectants and antiseptics (biocides). Antibiotic resistance has been well studied in bacteria, but little is known about potential biocide resistance genes and there have been few reported outbreaks in hospitals resulting from a breakdown in biocide effectiveness. Development of increased tolerance to biocides has been thought to be more difficult due to the mode of action of biocides which affect multiple cellular targets compared with antibiotics. Very few genes which contribute towards increased biocide tolerance have been identified. However, the majority of those that have are components or regulators of different efflux pumps or genes which modulate membrane function/modification. This review will examine the role of efflux in increased tolerance towards biocides, focusing on cationic biocides and heavy metals against Gram-negative bacteria. As many efflux pumps which are upregulated by biocide presence also contribute towards an antimicrobial resistance phenotype, the role of these efflux pumps in cross-resistance to both other biocides and antibiotics will be explored.
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Affiliation(s)
- Matthew E Wand
- Technology Development Group, UK Health Security Agency, Research and Evaluation, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK
| | - J Mark Sutton
- Technology Development Group, UK Health Security Agency, Research and Evaluation, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK
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Wu X, Zhan F, Zhang J, Chen S, Yang B. Identification of hypervirulent Klebsiella pneumoniae carrying terW gene by MacConkey-potassium tellurite medium in the general population. Front Public Health 2022; 10:946370. [PMID: 36091562 PMCID: PMC9448990 DOI: 10.3389/fpubh.2022.946370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/05/2022] [Indexed: 01/21/2023] Open
Abstract
Objectives To establish a MacConkey-potassium tellurium medium-based method for selectively culturing terW gene-positive Klebsiella pneumoniae (KP), to evaluate its performance and apply it to identifying particular clonal hypervirulent KP (hvKP) strains in epidemiological surveillance. Methods The virulence genes, rmpA, iutA, and terW, were detected by PCR. The minimum inhibitory concentration of potassium tellurite of hvKP (rmpA +/ iutA +) and classical KP (rmpA - and iutA -) was determined using the agar dilution method. The MacConkey medium containing 4 μg/ml potassium tellurite was prepared and the performance in detecting terW + KP was evaluated, including an agreement with PCR and positive/negative predictive value. Fecal samples from healthy volunteers in Fujian were collected and cultured in the medium, then positive strains were identified using MALDI-TOF MS, antimicrobial susceptibility was tested by Kirby-Bauer assays, and virulence genes and capsular serotype genes were tested by PCR. Results In KP isolated from clinical specimens (N = 198), the positive rate of terW was 37.9%, and the detection rate of terW in hvKP was significantly higher than that in classical KP (70.6% vs 13.3%). The potassium tellurite resistance levels of terW + (N = 75) and terW - (N = 55) KP were 8-128 μg/ml and <1-8 μg/ml, respectively, with significant differences. KP was selectively cultured on a MacConkey medium with 4 μg/ml potassium tellurite, and its agreement with PCR was good (Kappa=0.936), and the positive and negative percent agreement and positive and negative predictive values were 100% (75/75), 92.7% (51/55), 94.9% (75/79), and 100% (51/51), respectively. The prevalence of tellurite-resistant KP was 16.7% (86/516) in fecal samples from healthy volunteers, among which the positive rate of terW was 100% (86/86). The antimicrobial resistance characteristics of terW + KP showed no difference between healthy volunteers and inpatients. The most common capsular serotypes associated with high virulence were K1, K2, and K57. Conclusions The MacConkey medium containing 4 μg/ml potassium tellurite could easily select and culture terW + KP in fecal samples with high sensitivity and specificity, which is a practical method for the epidemic surveillance of hvKP in the general population.
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Affiliation(s)
- Xiufeng Wu
- Department of Laboratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Fuguo Zhan
- Department of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,First Clinical College, Fujian Medical University, Fuzhou, China
| | - Jiawei Zhang
- Department of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,First Clinical College, Fujian Medical University, Fuzhou, China
| | - Shanjian Chen
- Department of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,First Clinical College, Fujian Medical University, Fuzhou, China
| | - Bin Yang
- Department of Laboratory Medicine, Gene Diagnosis Research Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China,First Clinical College, Fujian Medical University, Fuzhou, China,*Correspondence: Bin Yang
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