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Emerging high-risk ST101 and ST307 carbapenem-resistant Klebsiella pneumoniae clones from bloodstream infections in Southern Italy.
- Source :
-
Annals of clinical microbiology and antimicrobials [Ann Clin Microbiol Antimicrob] 2020 Jun 01; Vol. 19 (1), pp. 24. Date of Electronic Publication: 2020 Jun 01. - Publication Year :
- 2020
-
Abstract
- Background: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) is an urgent public health issue in Italy. This pattern of resistance is due mainly to dissemination of carbapenemase genes. Molecular characterization of carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains was performed over a three-year period. In-depth analysis was performed on a subset of emerging CR-KP ST101 and ST307 clones.<br />Methods: A prospective study was performed on 691 patients with CR-KP bloodstream infections hospitalized in 19 hospitals located in three large provinces in Southern Italy. Carbapenemase genes were identified via genotyping methods. Multi-locus sequence typing (MLST) and Whole Genome Sequencing (WGS) were carried out on ST101 and ST307 isolates.<br />Results: Among the CR-KP isolates, bla <subscript>KPC</subscript> was found in 95.6%, bla <subscript>VIM</subscript> was found in 3.5%, bla <subscript>NDM</subscript> was found in 0.1% and bla <subscript>OXA-48</subscript> was found in 0.1%. The bla <subscript>KPC-3</subscript> variant was identified in all 104 characterized KPC-KP isolates. MLST of 231 representative isolates revealed ST512 in 45.5%, ST101 in 20.3% and ST307 in 18.2% of the isolates. cgMLST of ST307 and ST101 isolates revealed presence of more than one beta-lactam resistance gene. Amino acid substitution in the chromosomal colistin-resistance gene pmrB was found in two ST101 isolates.<br />Conclusions: ST512 is widespread in Southern Italy, but ST101 and ST307 are emerging since they were found in a significant proportion of cases. Aggressive infection control measures and a continuous monitoring of these high-risk clones are necessary to avoid rapid spread of CR-KP, especially in hospital settings.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Drug Resistance, Multiple, Bacterial genetics
Electrophoresis, Gel, Pulsed-Field
Female
Humans
Infant
Infant, Newborn
Italy epidemiology
Klebsiella pneumoniae enzymology
Male
Middle Aged
Molecular Epidemiology
Multilocus Sequence Typing
Prospective Studies
Real-Time Polymerase Chain Reaction
Serogroup
Whole Genome Sequencing
Young Adult
Bacterial Proteins genetics
Klebsiella Infections epidemiology
Klebsiella pneumoniae genetics
Klebsiella pneumoniae isolation & purification
beta-Lactamases genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1476-0711
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of clinical microbiology and antimicrobials
- Publication Type :
- Academic Journal
- Accession number :
- 32487201
- Full Text :
- https://doi.org/10.1186/s12941-020-00366-y