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Wang Y, Ouyang Y, Xu X, Sun S, Tian X, Liu H, Xia Y. Dissemination and characteristics of carbapenem-resistant Klebsiella pneumoniae in nine district hospitals in southwestern China. Front Microbiol 2023; 14:1269408. [PMID: 37942077 PMCID: PMC10628634 DOI: 10.3389/fmicb.2023.1269408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
Background Carbapenem-resistant Klebsiella pneumoniae (CRKP) is epidemically transmitted globally, but few studies focused on the prevalence in district-level hospitals. In this study, we investigated CRKP strains collected from nine district hospitals from September 2019 to September 2020, aiming to determine the resistance mechanisms, virulence profiles, and molecular epidemiological characteristics of CRKP in district hospitals in Southwest China. Methods A total of 51 CRKP strains were collected from 9 district-level hospitals. Matrix-assisted laser desorption/ionization-time of flight mass spectrometer was used for strain identification review, and the micro-broth dilution method was used for antibiotic sensitivity detection. Molecular epidemiological investigation of strains was performed by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) methods. PCR and efflux pump inhibition tests were used to detect CRKP resistance mechanisms. PCR and serum killing tests were used to detect capsular serotype, virulence-related genes, and virulence validation. Results The CRKP strains in district hospitals presented high levels of MIC50 and MIC90 in carbapenem antibiotics especially ertapenem and meropenem. A total of 90.2% (46/51) CRKP strains were detected as carbapenemase producers, and the proportion of strains co-expressing carbapenemases was 11.8% (6/51). All CRKP strains were grouped into eight MLST types, and ST11 was the most prevalent genotype. A total of 11.8% (6/51) CRKP isolates were positive for the string test, and three strains of hypervirulent and carbapenem-resistant K. pneumoniae (HV-CRKP) were positive in serum killing test. The molecular typing of all the CRKP isolates was grouped into 29 different PFGE patterns, and 40 ST11 isolates belonged to 20 different PFGE clusters. Conclusion CRKP strains showed high-level antibiotic resistance and virulence phenotype in district hospitals in Southwest China, which suggested that we should immediately pay attention to the rapid dissemination of the CRKP in regional hospitals. Our study will provide new insights into the epidemiology of CRKP in regional hospitals, which will help regional hospitals develop nosocomial infection prevention and control policies tailored to local conditions.
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Affiliation(s)
- Yonghong Wang
- Department of Clinical Laboratory, Chongqing Qianjiang Central Hospital, Chongqing University Qianjiang Hospital, Chongqing, China
- Qianjiang Key Laboratory of Chongqing Qianjiang Central Hospital Laboratory Medicine, Chongqing, China
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Ouyang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiuyu Xu
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shan Sun
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaolang Tian
- Department of Clinical Laboratory, The Fifth People’s Hospital of Chongqing, Chongqing, China
| | - Hang Liu
- Department of Clinical Laboratory, Institute of Translational Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yun Xia
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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2
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Liang Z, Wang Y, Lai Y, Zhang J, Yin L, Yu X, Zhou Y, Li X, Song Y. Host defense against the infection of Klebsiella pneumoniae: New strategy to kill the bacterium in the era of antibiotics? Front Cell Infect Microbiol 2022; 12:1050396. [PMID: 36506034 PMCID: PMC9730340 DOI: 10.3389/fcimb.2022.1050396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/10/2022] [Indexed: 11/25/2022] Open
Abstract
Klebsiella pneumoniae (K. pneumoniae) is a typical gram-negative iatrogenic bacterium that often causes bacteremia, pneumonia and urinary tract infection particularly among those with low immunity. Although antibiotics is the cornerstone of anti-infections, the clinical efficacy of β-lactamase and carbapenems drugs has been weakened due to the emergence of drug-resistant K. pneumoniae. Recent studies have demonstrated that host defense plays a critical role in killing K. pneumoniae. Here, we summarize our current understanding of host immunity mechanisms against K. pneumoniae, including mechanical barrier, innate immune cells, cellular immunity and humoral immunity, providing a theoretical basis and the new strategy for the clinical treatment of K. pneumoniae through improving host immunity.
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Affiliation(s)
- Zihan Liang
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, China,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China,College of Basic Medical Science, China Three Gorges University, Yichang, China
| | - Yiyao Wang
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, China,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China,College of Basic Medical Science, China Three Gorges University, Yichang, China
| | - Yixiang Lai
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, China,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China,College of Basic Medical Science, China Three Gorges University, Yichang, China
| | - Jingyi Zhang
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, China,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China,College of Basic Medical Science, China Three Gorges University, Yichang, China
| | - Lanlan Yin
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, China,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China,College of Basic Medical Science, China Three Gorges University, Yichang, China
| | - Xiang Yu
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, China,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China,College of Basic Medical Science, China Three Gorges University, Yichang, China
| | - Yongqin Zhou
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, China,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China,College of Basic Medical Science, China Three Gorges University, Yichang, China
| | - Xinzhi Li
- College of Basic Medical Science, China Three Gorges University, Yichang, China,Affiliated Renhe Hospital of China Three Gorges University, Yichang, China,*Correspondence: Yinhong Song, ; Xinzhi Li,
| | - Yinhong Song
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, China Three Gorges University, Yichang, China,Institute of Infection and Inflammation, China Three Gorges University, Yichang, China,College of Basic Medical Science, China Three Gorges University, Yichang, China,*Correspondence: Yinhong Song, ; Xinzhi Li,
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Chang EK, Miller M, Shahin K, Batac F, Field CL, Duignan P, Struve C, Byrne BA, Murray MJ, Greenwald K, Smith WA, Ziccardi M, Soto E. Genetics and pathology associated with Klebsiella pneumoniae and Klebsiella spp. isolates from North American Pacific coastal marine mammals. Vet Microbiol 2022; 265:109307. [DOI: 10.1016/j.vetmic.2021.109307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/30/2021] [Accepted: 12/11/2021] [Indexed: 01/01/2023]
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Porcine iucA+ but rmpA- Klebsiella pneumoniae strains proliferate in blood of young piglets but are killed by IgM and complement dependent opsonophagocytosis when these piglets get older. Vet Microbiol 2022; 266:109361. [DOI: 10.1016/j.vetmic.2022.109361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/20/2022]
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Environmental persistence and disinfectant susceptibility of Klebsiella pneumoniae recovered from pinnipeds stranded on the California Coast. Vet Microbiol 2019; 241:108554. [PMID: 31928701 DOI: 10.1016/j.vetmic.2019.108554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/11/2019] [Accepted: 12/17/2019] [Indexed: 01/08/2023]
Abstract
Hypermucoviscous K. pneumoniae (HMV) are emergent zoonotic pathogens associated with increased invasiveness and pathogenicity in terrestrial and marine mammals. In this study, HMV and non-HMV isolates recovered from stranded pinnipeds were used to investigate: 1) their persistence in sea and fresh water microcosms at 10 and 20°C, 2) their capacity to form biofilms, and 3) the biocide efficacy of four disinfectants on their planktonic and biofilm phenotypes. Results indicated that although HMV isolates were significantly more mucoviscous, non-HMV isolates displayed significantly greater capacity to form biofilms (p < 0.05). Additionally, non-HMV isolates persisted in greater numbers in both sea- and freshwater, particularly at 20°C. These two phenomena could be associated with the greater growth observed for non-HMV isolates in in-vitro growth-curve assays (p < 0.05). Similar susceptibility to disinfectants was detected in HMV and non-HMV isolates when exposed for 24 h; however, the minimal biofilm disinfectant eradication concentration for HMV isolates was significantly higher than that for non-HMV when exposed to disinfectants for 0.5 h. This information should be taken into consideration when developing biosecurity protocols in facilities holding marine mammals in captivity.
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Li G, Sun S, Zhao ZY, Sun Y. The pathogenicity of rmpA or aerobactin-positive Klebsiella pneumoniae in infected mice. J Int Med Res 2019; 47:4344-4352. [PMID: 31328596 PMCID: PMC6753543 DOI: 10.1177/0300060519863544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives To investigate the pathogenicity of Klebsiella
pneumoniae (KPN) possessing rmpA
or the aerobactin gene in infected mice. Methods BALB/c mice were divided into four groups (n = 10 per group) and
infected with: string test-positive and
rmpA-positive or aerobactin-positive KPN (group
1), string test-negative but rmpA-positive KPN
(group 2), string test-negative but aerobactin-positive KPN
(group 3), or string test- and
rmpA/aerobactin-negative KPN (group 4). Mouse
survival time was compared among groups, and the infection of
livers, spleens, lungs, and kidneys and KPN growth were assessed
in infected mice. Results Compared with the negative group (group 4), the survival rates of
mice infected with rmpA- or aerobactin-positive
KPN (groups 1–3) were significantly lower, their multi-organ
injuries were significantly more severe, and bacterial
enumeration was significantly higher. Conclusions Despite being string test-negative, aerobactin- or
rmpA-positive KPN still exhibit high
virulence and anti-immune effect activity. Therefore, the
combination of the string test and gene detection of aerobactin
and rmpA will be helpful in screening
hypervirulent KPN.
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Affiliation(s)
- Guili Li
- Department of Clinical Laboratory, Affiliated Hospital of Shandong Medical College, Shandong, China
| | - Shuhong Sun
- Department of Clinical Laboratory, Liny People's Hospital, Shandong, China
| | - Zhong Yuan Zhao
- Department of Clinical Medicine, Nanchang University, Nanchang, Jiangxi, China
| | - Yunfang Sun
- Department of Microbiology, Shandong Medical College, Linyi, Shandong, China
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Anzai EK, de Souza Júnior JC, Peruchi AR, Fonseca JM, Gumpl EK, Pignatari ACC, Hirano ZMB, Silveira ACDO. First case report of non-human primates (Alouatta clamitans) with the hypervirulent Klebsiella pneumoniae serotype K1 strain ST 23: A possible emerging wildlife pathogen. J Med Primatol 2017; 46:337-342. [PMID: 28809435 DOI: 10.1111/jmp.12296] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hypervirulent strain of Klebsiella pneumoniae genotype K1 isolates have recently emerged, causing severe pyogenic liver abscess complicated by devastating metastatic infections in humans. METHODS We describe a short outbreak of the non-human primate (NHP) research center, associated with a hypervirulent K. pneumoniae. The genetic similarity of the strains was evaluated by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) techniques, and virulence encoding genes were detected by polymerase chain reaction (PCR). RESULTS The isolates were phenotypically like strains causing community-acquired invasive liver abscess syndrome in humans. All strains exhibited identical PFGE patterns and were found to belong to ST23 and presented a hypermucovisity phenotype and possessed magA and rmpA gene. CONCLUSION This is the first case report of NHPs caused by K. pneumoniae displaying a hypermucoviscosity phenotype and belonging to capsular serotypes K1 and ST23.
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Affiliation(s)
- Eleine Kuroki Anzai
- Departamento de Medicina Veterinária, Universidade Regional de Blumenau (FURB), Blumenau, SC, Brazil
| | | | - Amanda Rezende Peruchi
- Departamento de Ciências Naturais, Universidade Regional de Blumenau (FURB), Blumenau, SC, Brazil
| | - Juliana Mello Fonseca
- Laboratório Especial de Microbiologia Clínica (LEMC), Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Elke Kreuscher Gumpl
- Laboratório Especial de Microbiologia Clínica (LEMC), Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Antônio Carlos Campos Pignatari
- Laboratório Especial de Microbiologia Clínica (LEMC), Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Soto E, Dennis MM, Beierschmitt A, Francis S, Sithole F, Halliday-Simmons I, Palmour R. Biofilm formation of hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae recovered from clinically affected African green monkey (Chlorocebus aethiops sabaeus). Microb Pathog 2017; 107:198-201. [PMID: 28366827 DOI: 10.1016/j.micpath.2017.03.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/24/2017] [Accepted: 03/28/2017] [Indexed: 11/25/2022]
Abstract
In recent years, an emergent Klebsiella pneumoniae hypermucoviscous (HMV) phenotype has been associated with increased invasiveness and pathogenicity in primates. The HMV phenotype is characterized by different capsular serotypes, associated with several genes including the rmpA (regulator of mucoid phenotype) and magA (mucoviscosity-associated) genes. In African green monkeys (AGM) (Chlorocebus aethiops sabaeus) serotypes K1 and K5 have been implicated in fatal multisystemic abscesses. In order to better understand the epizootiology of this pathogen, the capacity of biofilm production of K. pneumoniae isolates presenting the HMV was compared to non-HMV isolates at three different temperatures (25, 30 and 37 °C). The results indicate that HMV and non-HMV isolates display similar capacity to form biofilms at the three different evaluated temperatures. Temperature appears to play a role in the formation of biofilms by K. pneumoniae presenting the HMV phenotype, where larger biofilms were formed at 37 °C than at 25 °C. Knowledge regarding local environmental sources of K. pneumoniae and the possible role of wildlife in the maintenance of this agent in the area is necessary to develop effective recommendations for the prevention and management of this disease in captive AGM populations.
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Affiliation(s)
- Esteban Soto
- Department of Epidemiology and Medicine, University of California, Davis-School of Veterinary Medicine, Davis, CA, USA.
| | - Michelle M Dennis
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts, West Indies.
| | - Amy Beierschmitt
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts, West Indies; Behavioural Science Foundation, Estridge Estate, Saint Kitts, West Indies.
| | - Stewart Francis
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts, West Indies.
| | - Fortune Sithole
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts, West Indies.
| | - Iona Halliday-Simmons
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts, West Indies.
| | - Roberta Palmour
- Behavioural Science Foundation, Estridge Estate, Saint Kitts, West Indies; Faculty of Medicine, McGill University, Montréal, Québec, Canada.
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