Antibiotic Heteroresistance in Klebsiella pneumoniae

Stojowska-Swędrzyńska, Karolina; Łupkowska, Adrianna; Kuczyńska-Wiśnik, Dorota; Laskowska, Ewa

doi:10.3390/ijms23010449

Cited by 33 publications

(27 citation statements)

References 93 publications

(153 reference statements)

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“…IV. DISCUSSION K. pneumoniae is a significant multi-drug resistant gramnegative pathogen that causes different infectious diseases from UTI to pneumonia (Wang et al, 2020;Stojowska-Swędrzyńska et al, 2021). In the current study, 120 K. pneumoniae isolates have been collected from various clinical specimens with a peak incidence of 73.3% in urine.…”

Section: G Phenotypic Detection Of Extended-spectrum β-Lactamase Prod...mentioning

confidence: 99%

Bacteriological Characterization of Fluoroquinolones-Resistant Klebsiella pneumoniae Clinical Isolates During Covid-19 Pandemic

Masood

Yassin

2022

JLBSR

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The treatment of Klebsiella pneumoniae infections has become more difcult due to the emergence of multidrug-resistant strains. Fluoroquinolones have been widely used to treat respiratory tract infections and urinary tract infections caused by different bacteria. Therefore, this study aimed to evaluate fluoroquinolones resistance and detect ESBL producers in various clinical samples in Duhok Province, Iraq. K. pneumoniae was identied from different clinical samples by conventional microbiological tests. In addition, antibiotic susceptibility was detected by the KirbyBauer disc diffusion method. Out of 120 K. pneumoniae isolates, 73.3% were causing urinary tract infections, in most cases, 74.2% were among females and 25.8% among males, and among those 120 isolates, 76.7% of isolates were from outpatients, and 23.3% were inpatients. The resistance rate among all samples was 52.5%, 36.7%, 33.3%, 33.3%, ciprofloxacin, levofloxacin, norfloxacin, and ofloxacin, respectively in urine samples, the resistance to nalidixic acid was 22.5%. Among 120 samples, only 12 isolates were hypermucoviscosity. About 25% of ciprofloxacin and 17.5% of levofloxacin resistances were ESBL producers simultaneously. According to this study, K. pneumoniae is more susceptible to norfloxacin, ofloxacin, and nalidixic acid than ciprofloxacin and levofloxacin. Additionally, this study establishes a link between ESBL and fluoroquinolone resistance.

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Section: G Phenotypic Detection Of Extended-spectrum β-Lactamase Prod...mentioning

confidence: 99%

Bacteriological Characterization of Fluoroquinolones-Resistant Klebsiella pneumoniae Clinical Isolates During Covid-19 Pandemic

Masood

Yassin

2022

JLBSR

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“…It is hard to detect HR isolates because of the phenotypic and genetic instability of heteroresistant subpopulations(s) [ 24 ]. Routine antibiotic susceptibility methods may misinterpret the HR phenotypes [ 22 ].…”

Section: Hr Definition and Originsmentioning

confidence: 99%

“…However, it still cannot be implanted in routine clinical settings. Other alternative procedures, the disc diffusion assay and Epsilometer test (E-tests) have serious limitations of not being quantitative and showing high frequencies of false positive or false negative samples [ 2 , 16 , 24 ]. Culture-independent and biochemical methods, such as VITEK2, and PCR-based methods, such as the Xpert MTB/RIF, have been developed [ 2 , 12 ].…”

Section: Hr Definition and Originsmentioning

confidence: 99%

Relationships between Efflux Pumps and Emergence of Heteroresistance: A Comprehensive Study on the Current Findings

Abavisani

Kodori

Akrami

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Heteroresiatnce (HR) is the type of resistance toward one or more antibiotics appearing as a population of the bacterial load consisting of one or more subpopulations with lower antibiotic susceptibility levels than others. Due to the lack of appropriate diagnosis of HR isolates and their importance in resistance emergence to antibiotics, investigating the origins, emergence factors, and HR inhibitors is critical in combating antibiotic resistance. Efflux pumps (EPs) are bacterial systems that own an influential role in acquiring resistance toward anti-bacterial compounds. Studies on EPs revealed that they can affect HR emergence mechanisms and are competent to be introduced as a suitable bacterial target for diagnostic and therapeutic development in combating HR isolates. This review will consider the relations between EPs and the emergence of HR isolates and discuss their importance in confronting this type of antibiotic resistance.

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“…Klebsiella pneumoniae is an important pathogen causing nosocomial infection, pneumonia, urinary tract infection, bloodstream infection and a series of additional infectious diseases. 1 , 2 Carbapenems (imipenem, meropenem, ertapenem, etc.) are the most effective drugs for the treatment of Klebsiella pneumoniae , but in recent years, the frequent use of carbapenem antibiotics has led to a continuous increase in bacterial resistance.…”

Section: Introductionmentioning

confidence: 99%

Resistance Phenotype and Molecular Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae Isolated from Nanjing Children’s Hospital in Jiangsu Province, China

Tao¹,

Tan²,

Ma³

et al. 2022

IDR

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Objective The drug resistance phenotype and molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) were identified among children in Jiangsu Province, China. Methods CRKP strains were collected from the Children’s Hospital of Nanjing Medical University from December 2020 to March 2022. CRKP strains were characterized for further study: antimicrobial susceptibility testing, carbapenem resistance genes and homology analysis. Results Among 86 strains of CRKP, 85 carried carbapenemase genes; the dominant gene was bla KPC-2 (88.2%, 75/85), followed by bla NDM-1 (4.7%, 4/85), bla NDM-5 (4.7%, 4/85), bla IMP-8 (2.3%, 2/85), and bla OXA-181 (1.2%, 1/85). Among the 86 strains of CRKP, one isolate contained both the bla NDM-5 and bla OXA-181 genes, which is the first time that Klebsiella pneumoniae has been shown to jointly carry these genes in China. Another CRKP strain did not carry any carbapenemase gene. MLST analysis identified a total of 10 different sequence types, among which sequence type (ST) 11 was the most common. PFGE analysis identified 75 bla KPC-2 -producing CRKP ST11 strains, of which 68 were dominant clusters distributed among 11 different wards, mainly the neonatal medical centre (18 strains), neonatal surgery (17 strains) and cardiac care unit (CCU) (8 strains) wards. Conclusion Clonal dissemination of KPC-2-producing CRKP ST11 was observed in multiple departments. Additionally, non-ST11 strains showed high polymorphism based on molecular typing, indicating increasing diversity in CRKP strains. To our knowledge, this is the first report of NDM-5 and OXA-181-coproducing Klebsiella pneumoniae causing infection in children in China, which poses a significant health risk for paediatric patients. Active surveillance and effective control measures are urgently needed to prevent further transmission of these strains among children.

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Antibiotic Heteroresistance in Klebsiella pneumoniae

Cited by 33 publications

References 93 publications

Bacteriological Characterization of Fluoroquinolones-Resistant Klebsiella pneumoniae Clinical Isolates During Covid-19 Pandemic

Bacteriological Characterization of Fluoroquinolones-Resistant Klebsiella pneumoniae Clinical Isolates During Covid-19 Pandemic

Relationships between Efflux Pumps and Emergence of Heteroresistance: A Comprehensive Study on the Current Findings

Resistance Phenotype and Molecular Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae Isolated from Nanjing Children’s Hospital in Jiangsu Province, China

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