Extensively drug-resistant Klebsiella pneumoniae associated with complicated urinary tract infection Northern India
File(s)77_JJID.2023.009.pdf (3.63 MB)
Published version
Author(s)
Type
Journal Article
Abstract
Klebsiella pneumoniae (Kp), which is associated with hospital-acquired infections, is extensively drug-resistant (XDR), making treatment difficult. Understanding the genetic epidemiology of XDR-Kp can help determine its potential to be hypervirulent (hv) through the presence of siderophores. We characterized the genomes of 18 colistin-resistant XDR-Kp isolated from 14 patients with complicated tract infection at an Indian healthcare facility. The 18 organisms comprised the following sequence types (STs): ST14 (n = 9), ST147 (n = 5), ST231 (n = 2), ST2096 (n = 1), and ST25 (n = 1). Many patients in each ward were infected with the same ST, suggesting a common source of infection. Some patients had recurrent infections with multiple STs circulating in the ward, providing evidence of hospital transmission. β-lactamase genes (blaCTX-M-1, blaSHV, and blaampH) were present in all isolates. blaNDM-1 was present in 15 isolates, blaOXA-1 in 16 isolates, blaTEM-1D in 13 isolates, and blaOXA-48 in 3 isolates. Disruption of mgrB by various insertion sequences was responsible for colistin resistance in 6 isolates. The most common K-type among isolates was K2 (n = 10). One XDR convergent hvKp ST2096 mutation (iuc+ybt+blaOXA-1+blaOXA-48) was associated with prolonged hospitalization. Convergent XDR-hvKp has outbreak potential, warranting effective antimicrobial stewardship and infection control.
Date Issued
2024-01-31
Date Acceptance
2023-08-08
Citation
Japanese Journal of Infectious Diseases, 2024, 77 (1), pp.7-15
ISSN
1344-6304
Publisher
National Institute of Infectious Diseases
Start Page
7
End Page
15
Journal / Book Title
Japanese Journal of Infectious Diseases
Volume
77
Issue
1
Copyright Statement
© 2024 Authors
License URL
Identifier
http://dx.doi.org/10.7883/yoken.jjid.2023.009
Publication Status
Published
Date Publish Online
2023-08-31