Molecular characterization of clinical multidrug-resistant Klebsiella pneumoniae isolates

Klebsiella pneumoniae is a frequent nosocomial pathogen, with the multidrug-resistant (MDR) K. pneumoniae being a major public health concern, frequently causing difficult-to-treat infections worldwide. The aim of this study was to investigate the molecular characterization of clinical MDR Klebsiella pneumoniae isolates. A total of 27 non-duplicate MDR K. pneumoniae isolates with a CTX-CIP-AK resistance pattern were investigated for the prevalence of antimicrobial resistance genes including extended spectrum β-lactamase genes (ESBLs), plasmid-mediated quinolone resistance (PMQR) genes, 16S rRNA methylase (16S-RMTase) genes, and integrons by polymerase chain reaction (PCR) amplification and DNA sequencing. Plasmid replicons were typed by PCR-based replicon typing (PBRT). Multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were carried out to characterize the strain relatedness. All the isolates co-harbored 3 or more resistance determinants. OqxAB, CTX-M-type ESBLs and RmtB were the most frequent determinants, distributed among19 (70.4%),18 (66.7%) and 8 (29.6%) strains. Fourteen isolates harbored class 1 integrons, with orfD-aacA4 being the most frequent gene cassette array. Class 3 integrons were less frequently identified and contained the gene cassette array of blaGES-1-blaOXA-10-aac(6′)-Ib. IncFII replicon was most commonly found in this collection. One cluster was observed with ≥80% similarity among profiles obtained by PFGE, and one sequence type (ST) by MLST, namely ST11, was observed in the cluster. K. pneumoniae carbapenemase (KPC)–producing ST11 was the main clone detected. Of particular concern was the high prevalence of multiple resistance determinants, classs I integrons and IncFII plasmid replicon among these MDR strains, which provide advantages for the rapid development of MDR strains.

• Publication year

  2014

• Venue

  Annals of Clinical Microbiology and Antimicrobials

• Publication date

  2014-05-01

• Fields of study

  Biology, Medicine

• Identifiers
  DOI 10.1186/1476-0711-13-16PMID 24884610PMCID 4030571
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• IncFII replicon was the most common plasmid replicon, and a single ST11 cluster contained the main KPC-producing ST11 clone.

  Confidence 0.95

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• OqxAB, CTX-M-type ESBLs, and RmtB were the most frequent resistance determinants, found in 19, 18, and 8 isolates, respectively.

  Confidence 0.98

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• Class 1 integrons were detected in 14 isolates, and orfD-aacA4 was the most frequent gene cassette array.

  Confidence 0.96

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review

• class 1 integrons

  genetic elements

  Mobile genetic elements that capture and express resistance gene cassettes in bacteria.

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• ctx-m-type esbls

  gene families

  A family of CTX-M extended-spectrum beta-lactamase genes analyzed in the isolates.

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• incfii replicon

  plasmid replicons

  A plasmid replicon type identified by PCR-based replicon typing in the isolate set.

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• kpc-producing st11

  clones

  An ST11 clone characterized by carriage of KPC carbapenemase genes.

  Aliases: KPC-producing ST11 clone

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• oqxab

  gene families

  A plasmid-mediated quinolone resistance determinant examined in the Klebsiella pneumoniae isolates.

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• orfd-aaca4

  gene cassette arrays

  A gene cassette array detected within class 1 integrons in the isolate collection.

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• rmtb

  gene families

  A 16S rRNA methylase resistance gene surveyed among the isolates.

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review
• st11

  sequence types

  A multilocus sequence type used to classify related Klebsiella pneumoniae isolates.

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewKiller Whale (322360f1c1) review

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