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The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla(NDM/OXA-48) carbapenemases in a tertiary care center of Iran

BACKGROUND: Klebsiella pneumoniae is a public health concern because of its ability to develop multidrug resistance and hypervirulent genotypes, of those capsular types K1 and K2 cause community and nosocomial life-threatening infections. This study aimed to determine the antibiotic susceptibility p...

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Autores principales: Pajand, Omid, Darabi, Narges, Arab, Maedeh, Ghorbani, Raheb, Bameri, Zakaria, Ebrahimi, Ali, Hojabri, Zoya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110786/
https://www.ncbi.nlm.nih.gov/pubmed/32234050
http://dx.doi.org/10.1186/s12941-020-00349-z
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author Pajand, Omid
Darabi, Narges
Arab, Maedeh
Ghorbani, Raheb
Bameri, Zakaria
Ebrahimi, Ali
Hojabri, Zoya
author_facet Pajand, Omid
Darabi, Narges
Arab, Maedeh
Ghorbani, Raheb
Bameri, Zakaria
Ebrahimi, Ali
Hojabri, Zoya
author_sort Pajand, Omid
collection PubMed
description BACKGROUND: Klebsiella pneumoniae is a public health concern because of its ability to develop multidrug resistance and hypervirulent genotypes, of those capsular types K1 and K2 cause community and nosocomial life-threatening infections. This study aimed to determine the antibiotic susceptibility patterns and genotypic traits of a collection of Klebsiella spp. isolates. Furthermore, the clonal relatedness of bla(NDM) producing strains was investigated. METHODS: During a 19-months  surveillance study, 122 Klebsiella spp. isolates were cultured from extraintestinal specimens of patients admitted to the tertiary referral hospital in Semnan, Iran. Isolates were identified using biochemical tests and subjected to determination of phylogroups, capsular types and virulence/resistance genes content. Hypervirulent K. pneumoniae (hvKp) strains were detected genotypically, and Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR fingerprinting was used to determine the clonality of bla(NDM) producing strains. RESULTS: Multidrug resistant phenotype was detected in 75 (61.5%) isolates and amikacin was found as the most potent antibiotic with the susceptibility rate of 85.2%. The carbapenemase genes were detected in 45 (36.8%) strains, including 21 (17.2%) bla(OXA-48), 7 (5.6%) bla(NDM-1), 14 (11.4%) bla(NDM-1/OXA-48) and 3 (2.4%) bla(IMP-) carrying strains, while 55 (45.08%) isolates showed carbapenem resistant phenotype. The first bla(NDM-1) carrying strain was cultured from a sputum specimen on March 2015, while the last positive one was recovered from blood culture on September 2016. Most of the isolates (80.3%) belonged to phylogroup I, and bla(NDM-1) was identified among all three phylogroups. The ERIC-PCR clustered the 101 bla(NDM) negative and 21 bla(NDM-1) positive isolates into 25 and five clusters, respectively, and the latter group belonged to clonal complex 147 (CC147). One K1 and 15 K2 bla(NDM-1) negative isolates were detected, of those three strains were identified as hvKp. Five K2 positive strains, including four bla(OXA-48) producer and one hvKp sequence type 86 (ST86) were carbapenem resistant. Among carbapenem resistant isolates, CC147 strains harboured higher rates of siderophores iutA and ybtS. CONCLUSION: The present findings showed a hospital circulation of CC147 bla(NDM-1) or bla(NDM-1/OXA-48) producing strains, disseminated in different wards. The hvKp/ST86 strain expressing K2 capsular type and carbapenem resistant phenotype wasn’t reported from Iran so far. So, it seems that we must be aware of the emergence and spread of new K. pneumoniae clones associated with resistant and hypermucoviscous phenotypes.
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spelling pubmed-71107862020-04-07 The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla(NDM/OXA-48) carbapenemases in a tertiary care center of Iran Pajand, Omid Darabi, Narges Arab, Maedeh Ghorbani, Raheb Bameri, Zakaria Ebrahimi, Ali Hojabri, Zoya Ann Clin Microbiol Antimicrob Research BACKGROUND: Klebsiella pneumoniae is a public health concern because of its ability to develop multidrug resistance and hypervirulent genotypes, of those capsular types K1 and K2 cause community and nosocomial life-threatening infections. This study aimed to determine the antibiotic susceptibility patterns and genotypic traits of a collection of Klebsiella spp. isolates. Furthermore, the clonal relatedness of bla(NDM) producing strains was investigated. METHODS: During a 19-months  surveillance study, 122 Klebsiella spp. isolates were cultured from extraintestinal specimens of patients admitted to the tertiary referral hospital in Semnan, Iran. Isolates were identified using biochemical tests and subjected to determination of phylogroups, capsular types and virulence/resistance genes content. Hypervirulent K. pneumoniae (hvKp) strains were detected genotypically, and Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR fingerprinting was used to determine the clonality of bla(NDM) producing strains. RESULTS: Multidrug resistant phenotype was detected in 75 (61.5%) isolates and amikacin was found as the most potent antibiotic with the susceptibility rate of 85.2%. The carbapenemase genes were detected in 45 (36.8%) strains, including 21 (17.2%) bla(OXA-48), 7 (5.6%) bla(NDM-1), 14 (11.4%) bla(NDM-1/OXA-48) and 3 (2.4%) bla(IMP-) carrying strains, while 55 (45.08%) isolates showed carbapenem resistant phenotype. The first bla(NDM-1) carrying strain was cultured from a sputum specimen on March 2015, while the last positive one was recovered from blood culture on September 2016. Most of the isolates (80.3%) belonged to phylogroup I, and bla(NDM-1) was identified among all three phylogroups. The ERIC-PCR clustered the 101 bla(NDM) negative and 21 bla(NDM-1) positive isolates into 25 and five clusters, respectively, and the latter group belonged to clonal complex 147 (CC147). One K1 and 15 K2 bla(NDM-1) negative isolates were detected, of those three strains were identified as hvKp. Five K2 positive strains, including four bla(OXA-48) producer and one hvKp sequence type 86 (ST86) were carbapenem resistant. Among carbapenem resistant isolates, CC147 strains harboured higher rates of siderophores iutA and ybtS. CONCLUSION: The present findings showed a hospital circulation of CC147 bla(NDM-1) or bla(NDM-1/OXA-48) producing strains, disseminated in different wards. The hvKp/ST86 strain expressing K2 capsular type and carbapenem resistant phenotype wasn’t reported from Iran so far. So, it seems that we must be aware of the emergence and spread of new K. pneumoniae clones associated with resistant and hypermucoviscous phenotypes. BioMed Central 2020-03-31 /pmc/articles/PMC7110786/ /pubmed/32234050 http://dx.doi.org/10.1186/s12941-020-00349-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Pajand, Omid
Darabi, Narges
Arab, Maedeh
Ghorbani, Raheb
Bameri, Zakaria
Ebrahimi, Ali
Hojabri, Zoya
The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla(NDM/OXA-48) carbapenemases in a tertiary care center of Iran
title The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla(NDM/OXA-48) carbapenemases in a tertiary care center of Iran
title_full The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla(NDM/OXA-48) carbapenemases in a tertiary care center of Iran
title_fullStr The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla(NDM/OXA-48) carbapenemases in a tertiary care center of Iran
title_full_unstemmed The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla(NDM/OXA-48) carbapenemases in a tertiary care center of Iran
title_short The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring bla(NDM/OXA-48) carbapenemases in a tertiary care center of Iran
title_sort emergence of the hypervirulent klebsiella pneumoniae (hvkp) strains among circulating clonal complex 147 (cc147) harbouring bla(ndm/oxa-48) carbapenemases in a tertiary care center of iran
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110786/
https://www.ncbi.nlm.nih.gov/pubmed/32234050
http://dx.doi.org/10.1186/s12941-020-00349-z
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