Carbapenem-resistant Klebsiella pneumoniae : the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge

Expert Review of Anti-infective Therapy, Год журнала: 2024, Номер 22(1-3), С. 25 - 43

Опубликована: Янв. 18, 2024

Introduction Klebsiella pneumoniae is a major agent of healthcare-associated infections and cause some community-acquired infections, including severe bacteremic associated with metastatic abscesses in liver other organs. Clinical relevance compounded by its outstanding propensity to evolve antibiotic resistance. In particular, the emergence dissemination carbapenem resistance K. has posed challenge due few residual treatment options, which have only recently been expanded new agents. The epidemiological success carbapenem-resistant (CR-Kp) mainly linked clonal lineages that produce carbapenem-hydrolyzing enzymes (carbapenemases) encoded plasmids.

Язык: Английский

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Virulence factors in carbapenem-resistant hypervirulent Klebsiella pneumoniae

Frontiers in Microbiology, Год журнала: 2023, Номер 14

Опубликована: Ноя. 30, 2023

Hypervirulence and carbapenem-resistant have emerged as two distinct evolutionary pathotypes of Klebsiella pneumoniae, with both reaching their epidemic success posing a great threat to public health. However, the boundaries separating these fade, we assist worrisome convergence in certain high-risk clones, causing hospital outbreaks challenging every therapeutic option available. To better understand basic biology pathogens, this review aimed describe virulence factors distribution worldwide among highly virulent or hypervirulent K. pneumoniae strains, well interplay strains carbapenemase produced sequence type such strains. As witness shift healthcare settings where are beginning emerge replace classical understanding is urgently needed for immediate appropriate response.

Язык: Английский

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Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence

hLife, Год журнала: 2024, Номер unknown

Опубликована: Июнь 1, 2024

The emergence of hypervirulence (hv) and carbapenem resistance (CR) as distinct evolutionary directions for Klebsiella pneumoniae presents a significant threat in clinical settings. However, recent years, there has been growing identification K. strains that integrate both phenotypes, resulting severe outcomes. Carbapenem-resistant hypervirulent (CRhvKP) typically emerges through the acquisition plasmids carrying either virulence or CR-encoded genes by carbapenem-resistant pneumoniae. Furthermore, hybrid plasmid can confer combination CR hv. CRhvKP cause variety infections, including pneumonia, urinary tract bloodstream liver abscesses, other related conditions. While sequence type 11 (ST11) dominates majority China, molecular factors responsible success ST11 largely remain unknown. Here, we provide an overview current understanding variation distribution crucial determinants, mechanisms driving merging hv CR, potential influencing epidemiological CRhvKP. This research aims to contribute comprehensive complexities surrounding It is imperative underscore development therapies, precision medicine, vaccine strategies pivotal approaches effectively combating Considering widespread prevalence CRhvKP, prioritized, multifaceted approach encompassing infection control, active surveillance, innovative therapeutics essential.

Язык: Английский

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Mechanisms of Antimicrobial Resistance in Klebsiella: Advances in Detection Methods and Clinical Implications

Infection and Drug Resistance, Год журнала: 2025, Номер Volume 18, С. 1339 - 1354

Опубликована: Март 1, 2025

Abstract: Klebsiella spp . are ubiquitous gram-negative bacteria, commonly present in natural environments and as part of the human microbiota. is involved occurrence development many diseases, effective antibiotics for it have attracted attention researchers. In recent years, its multi-drug resistance, particularly to carbapenems β-lactam antibiotics, has posed significant challenges clinical treatment. Therefore, a comprehensive understanding resistance mechanisms , along with enhancement detection methods, crucial effectively controlling spread drug-resistant strains guiding individualized This paper systematically reviews epidemiological characteristics, mechanisms, treatment strategies aiming provide new insights management this pathogen. Keywords: drug method, β-lactam,

Язык: Английский

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Nanoplastics facilitate the spread of antibiotic resistance genes in chemically induced competent bacteria: The hydrogen peroxide plays as the main signal factor

Journal of environmental chemical engineering, Год журнала: 2025, Номер unknown, С. 115375 - 115375

Опубликована: Янв. 1, 2025

Язык: Английский

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Distribution and influencing factors of antibiotic resistance genes in two mussel species along the coasts of the East China Sea and the Yellow Sea

Journal of Hazardous Materials, Год журнала: 2025, Номер unknown, С. 137399 - 137399

Опубликована: Янв. 1, 2025

Язык: Английский

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Outbreak of High-Risk Clone ST323 Klebsiella pneumoniae Resistant to Ceftazidime–Avibactam Due to Acquisition of blaVEB-25 and to Cefiderocol Due to Mutated fiu Gene

Antibiotics, Год журнала: 2025, Номер 14(3), С. 223 - 223

Опубликована: Фев. 21, 2025

Background/Objectives: The incidence of Ceftazidime/Avibactam (CZA)-resistant Klebsiella pneumoniae isolate co-producing carbapenemase 2 (KPC-2) and Vietnamese extended-spectrum β-lactamase 25 (VEB-25) has been on the rise in Greece over past five years. This study investigates isolation ST323 K. isolates co-resistant to CZA cefiderocol (FDC) from colonized infected patients a single hospital Athens. Methods: CZA-resistant strains were isolated 5 ICU 27 December 2023 22 January 2024. Antimicrobial susceptibility was tested against panel agents. Whole-genome sequencing carried out identify acquired resistance genes mutations that associated with FDC resistance. Results: belonged harbored blaKPC-2 blaVEB-25. had minimum inhibitory concentration (MIC) >256 mg/L for 32 FDC, due disrupted catecholate siderophore receptor Fiu. blaVEB-25 located an IncC non-conjugative plasmid ~14 kb multidrug (MDR) region comprising 15 further genes. Transformation studies showed blaVEB-25-carrying provided most β-lactams tested, including CZA. remained susceptible carbapenems, imipenem/relebactam, meropenem/vaborbactam. citrate-dependent iron (III) uptake system (fecIRABCDE), which increased MIC ≤0.08 mg/L. Conclusions: gene plasmids are important contributors spread key antibiotic Strict infection control measures must be elaborated upon prevent extensively drug-resistant organisms such as those described here.

Язык: Английский

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Molecular epidemiology and genetic dynamics of carbapenem-resistant hypervirulent Klebsiella pneumoniae in China

Frontiers in Cellular and Infection Microbiology, Год журнала: 2025, Номер 15

Опубликована: Фев. 14, 2025

Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CRhvKP) poses a significant global health threat due to its enhanced virulence and resistance. This study analyzed 5,036 publicly available K. genomes from China (2005–2023), identifying 1,538 CRhvKP genomes, accounting for 44.6% of carbapenem-resistant isolates 69.5% isolates. Predominant carbapenemases included bla KPC (92.1%), with an increasing prevalence NDM OXA-48-like genes. Most (93.6%) carried both aerobactin yersiniabactin The genetic background showed high diversity, characterized by 36 sequence types (STs) 22 capsule types, high-risk endemic STs such as ST11, ST15, ST23 being predominant. demonstrated virulence, whereas ST11 more resistance genes but minimal presence iroBCDN A core genome MLST analysis revealed that 89.0% clustered into 131 clonal groups, indicating widespread dissemination, particularly in eastern China. CR hv plasmids, primarily IncF, IncH, IncR distinct community structures, plasmids demonstrating higher mobility diversity. Crucially, we identified 40 CR-hv convergent across five STs, likely resulting plasmid fusions, which have become increasingly prevalent over the last decade. Furthermore, chromosomal integration KPC-2 was detected, underscoring stable inheritance these traits. Class 1 Integrons were present 84.5% strains, most notably least ST23. These integrons harbored confer various antibiotics, including IMP VIM , their content varying different STs. highlights complexity, rapid China, emphasizing urgent need genomic surveillance targeted interventions mitigate posed multidrug-resistant strains.

Язык: Английский

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Emergence and persistent spread of carbapenemase-producing Klebsiella pneumoniae high-risk clones in Greek hospitals, 2013 to 2022

Eurosurveillance, Год журнала: 2023, Номер 28(47)

Опубликована: Ноя. 23, 2023

Background Preliminary unpublished results of the survey carbapenem- and/or colistin-resistant Enterobacterales (CCRE survey) showed expansion carbapenemase-producing Klebsiella pneumoniae (CPKP) sequence type (ST) 39 in 12 15 participating Greek hospitals 2019. Aim We conducted a rapid to determine extent spread CPKP high-risk clones 2022 and compare distribution circulating these since 2013. Methods analysed whole genome sequences epidemiological data 310 K. isolates that were carbapenem-resistant or ‘susceptible, increased exposure’ from participated European Enterobacteriaceae (EuSCAPE, 2013–2014), CCRE (2019) national follow-up (2022) including, for latter, an estimation transmission events. Results Five STs including ST258/512 (n = 101 isolates), ST11 93), ST39 56), ST147 21) ST323 13) accounted more than 90% dataset. While ST11, have been detected 2013 2014, KPC-2-producing emerged 2019 2022, respectively. Based on defined genetic relatedness cut-off, 44 within-hospital events identified dataset, with having at least one event. Conclusion The recent emergence new healthcare system related is concern highlights need molecular surveillance enhanced infection prevention control measures.

Язык: Английский

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Coexistence of blaNDM-5, blaCTX-M-15, blaOXA-232, blaSHV-182 genes in multidrug-resistant K. pneumoniae ST437-carrying OmpK36 and OmpK37 porin mutations: First report in Italy

Journal of Global Antimicrobial Resistance, Год журнала: 2024, Номер 37, С. 24 - 27

Опубликована: Фев. 24, 2024

K. pneumoniae is a common cause of severe hospital-acquired infections. In the present study, we have characterised whole-genome two ST437 belonging to clonal complex CC258. The sequencing was performed by MiSeq Illumina, with 2 × 300bp paired-end run. ResFinder 4.4.2 used detect acquired antimicrobial resistance genes (ARGs) and chromosomal mutations. Mobile genetic elements (plasmids ISs) were identified MobileElementFinder v1.0.3. genome also assigned ST using MLST 2.0.9. Virulence factors detected Factor Database (VFDB). KPNAQ_1/23 KPNAQ_2/23 strains, isolated from urine samples hospitalised patients, showed most antibiotics, including ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam combinations. Both strains susceptible only cefiderocol. Multiple mechanisms identified. Resistance β-lactams due presence NDM-5, OXA-232, CTX-M-15, SHV-182 β-lactamases, OmpK36 OmpK37 porin fluoroquinolones mediated mutations in acrR, oqxAB efflux pumps, bifunctional gene aac(6')-Ib-cr. different virulence makes these high-risk clones.

Язык: Английский

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