Distribution of mcr-1 Harboring Hypervirulent Klebsiella pneumoniae in Clinical Specimens and Lytic Activity of Bacteriophage KpnM Against Isolates

Abstract

Background The World Health Organization (WHO) has declared the multi-drug resistant (MDR) Klebsiella pneumoniae as one of the critical bacterial pathogens. The dearth of new antibiotics and inadequate therapeutic options necessitate finding alternative options. Bacteriophages are known as enemies of bacteria and are well-recognized to fight MDR pathogens. Methods A total of 150 samples were collected from different clinical specimens through a convenient sampling technique. Isolation, identification, and antibiotic susceptibility testing (AST) of K. pneumoniae were done by standard and validated microbiological procedures. Molecular identification of virulence factors and antibiotic resistance genes (ARGs) was carried out through polymerase chain reaction (PCR) by using specific primers. For bacteriophage isolation, hospital sewage samples were processed for phage enrichment, purification, and further characterization ie, transmission electron microscopy (TEM) and stability testing, etc. followed by evaluation of the lytic potential of the phage. Results Overall, a total of 41% of isolates of K. pneumoniae were observed as hypervirulent K. pneumoniae (hvKp). Among hvKp, a total of 12 (42%) were detected as MDR hvKp. A total of 37% of all MDR isolates were found resistant to colistin, and 66% of the colistin resistance isolates were recorded as mcr-1 positive. Isolated phage KpnM had shown lytic activity against 53 (79%) K. pneumoniae isolates. Remarkably, all 8 mcr-1 harboring MDR hvKp and non-hvKp isolates were susceptible to KpnM phage. Conclusion Significant distribution of mcr-1 harboring hypervirulent Klebsiella pneumoniae was observed in clinical specimens, which is worrisome for the health system of the country. Characterized phage KpnM exhibited encouraging results and showed the lytic activity against the mcr-1 harboring hvKp isolates, which may be used as a prospective alternative control strategy to fight this ominous bacterium.

A Response to Article “Distribution of Mcr-1 Harboring Hypervirulent Klebsiella Pneumoniae in Clinical Specimens and Lytic Activity of Bacteriophage KpnM Against Isolates” [Letter]

“…We really appreciate the authors and all collaborators who have recently reported their research results in an article entitled “Distribution of Mcr-1 Harboring Hypervirulent Klebsiella Pneumoniae in Clinical Specimens and Lytic Activity of Bacteriophage KpnM Against Isolates”. 1 This study had shown very encouraging research results and important information regarding the use of bacteriophage; KpnM phage in this case, which could be further studied for combating the antibiotic resistance issues. However, first of all, this study lacks clear determination of “hypervirulent” bacteria.…”

A Response to Article “Distribution of Mcr-1 Harboring Hypervirulent Klebsiella pneumoniae in Clinical Specimens and Lytic Activity of Bacteriophage KpnM Against Isolates” [Response to Letter]

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We acknowledge the effort made by the author to craft the response to our recent publication in infection and drug resistance. 1 We are pleased that the author appreciated our work and found the results of the study promising to fight antibiotic resistance and resistant superbugs like Klebsiella pneumoniae. In addition to that, the author raised some fair queries regarding the methods and suggested possible explications.

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The Rapid Emergence of Hypervirulent Klebsiella Species and Burkholderia pseudomallei as Major Health Threats in Southeast Asia: The Urgent Need for Recognition as Neglected Tropical Diseases

“…Cases of HvKp are being reported more frequently globally, in wider Asia [ 71 , 79 , 80 , 81 ], Western Europe [ 82 , 83 , 84 , 85 , 86 ], Scandinavia [ 87 , 88 ], North America [ 63 , 88 , 89 , 90 ], South America [ 91 ], and Southern Africa [ 51 , 88 ]. This shows an ability for HvKp to spread into new environments and populations.…”

“…The confluence of multi-drug resistance and hypervirulence has led to the development of extended-spectrum β-lactamase-producing HvKp (ESBL-HvKp) [ 49 , 109 ] and hypervirulent carbapenem-resistant Klebsiella pneumoniae (Hv-CRKp) strains [ 49 , 72 , 103 ]. These MDR-HvKp strains have been detected in Southeast Asia [ 68 , 72 ] and are spreading worldwide [ 49 , 79 , 103 , 109 , 110 , 111 ].…”