Genetic characteristics of one highly multi-drug-resistant strain of Klebsiella ozaenae

Huang, Jiansheng; Li, Xirong; Zhu, Nianyong; Li, Guoxiong

doi:10.1099/jmm.0.044115-0

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…Huang et al reported one highly multi-drug -resistant strain of K. ozaenae which was isolated from an ICU patient and resistant to most of the tested antimicrobials, including imipenem, ertapenem, ampicillin/sulbactam, piperacillin-tazobactam, aztreonam, ceftazidime, cefepime, levofloxacin and ciprofloxacin, but it was sensitive to gentamicin. 10 Abbas et al reported similar results: in their study, the K. ozaenae isolate was multi-resistant to most tested antibiotics, including amoxicillin, cephalothin, ceftazidime, cefotaxime, amikacin, tetracycline, naldixic acid, erythromycin and trimethoprim, but it was sensitive to imipenem and gentamicin. 11 In another cross-sectional retrospective study, performed by Radji et al, the authors collected specimens from 385 patients, of which 249 (64.68%) were cultured positive, including 21 that were positive for K. ozaenae.…”

Section: Discussionmentioning

confidence: 60%

“…ozaenae is sensitive or intermediately sensitive to antimicrobials including cotrimoxazole, cephalosporins, quinolones, tetracyclines and aminoglycosides; however, which kind of antimicrobial to use in the treatment of K. ozaenae infections remains uncertain due to drugresistance. 10 Therefore, an antibiotic susceptibility test should be performed before treatment to guide the antimicrobials use. Huang et al reported one highly multi-drug -resistant strain of K. ozaenae which was isolated from an ICU patient and resistant to most of the tested antimicrobials, including imipenem, ertapenem, ampicillin/sulbactam, piperacillin-tazobactam, aztreonam, ceftazidime, cefepime, levofloxacin and ciprofloxacin, but it was sensitive to gentamicin.…”

Section: Discussionmentioning

confidence: 99%

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Multi-Organ Abscesses and 5th Cervical Vertebra Bone Destruction Related with Klebsiella ozaenae Infection: A Case Report

Wu¹,

Yang²,

Wang³

et al. 2020

IDR

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Klebsiella ozaenae (K. ozaenae) is a causative pathogen of some rare diseases such as primary atrophic rhinitis and ozena. Here, we describe one case of a potentially lethal kind of K. ozaenae infection in which multiple organs were implicated. A 40-year-old diabetic male patient presented to our hospital due to fever with right anterior chest mass and neck and shoulder pain for half a month. Based on all examination results, he was diagnosed with sepsis, bilateral pulmonary/right chest wall/liver abscesses and 5th cervical vertebra bone destruction with prevertebral abscesses, all related with K. ozaenae infection. During the first time of admission, he was treated with antimicrobials without operations. Twelve days after his first discharge, fever and pain occurred again, the patient was treated with antimicrobials, operations (anterior debridement, spinal canal decompression, iliac bone graft fusion and internal fixation) and rehabilitation at second admission. The patient recovered well and was discharged from hospital. This case report demonstrates that K. ozaenae can trigger a wide range invasive infections. Particularly, 5th cervical vertebra bone destruction was first reported as a clinical manifestation of K. ozaenae infection in our patient.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Multi-Organ Abscesses and 5th Cervical Vertebra Bone Destruction Related with Klebsiella ozaenae Infection: A Case Report

Wu¹,

Yang²,

Wang³

et al. 2020

IDR

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“…Species were further identified using an automated mass spectrometry microbial identification system (MALDI-TOF, Bruker, USA) and re-confirmed by 16S rRNA, RecN , and Hsp60 sequencing (Hoffmann and Roggenkamp, 2003 ; Ribeiro et al, 2015 ). Common carbapenemase-encoding genes, including bla KPC , bla NDM , bla VIM , bla IMP , bla GES , bla SME , bla IMI , bla SIM , bla GIM , bla SPM , bla OXA−23 , bla OXA−24 , and bla OXA−58 , from all 156 isolates were amplified, and amplicons were sequenced (Pfeifer et al, 2010 ; Huang et al, 2012 ; Zhang et al, 2017 , 2018 ). Plasmids of the untypeable incompatibility group, represented by pCKPC18-1 (CP022276), were screened by specific primers (UTF-TGCATCGATACGTTCCTGCA and UTR-ACTCGCTAGCATGGAACATC) targeting the replication initiator ( repA ).…”

Section: Methodsmentioning

confidence: 99%

Further Spread of a blaKPC-Harboring Untypeable Plasmid in Enterobacteriaceae in China

et al. 2018

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The wide spread of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae is great threat to public health in China. Plasmids are among the major factors mediating blaKPC gene dissemination. A total of 156 carbapenem-resistant Enterobacteriaceae (CRE) isolates were identified in a tertiary hospital in China. Six KPC-producing isolates, namely, E. coli (n = 2), E. asburiae (n = 1), C. freundii (n = 1), C. portucalensis (n = 1), and C. koseri (n = 1), tested positive for the pCKPC18-1-like untypeable plasmid, which was described recently in C. freundii. All 6 plasmids could be easily transferred into E. coli by chemical transformation or conjugation and were confirmed by sequencing to harbor blaKPC−2. Multilocus PCRs and EcoRI-RFLP revealed that the 6 untypeable plasmids belonged to 2 isoforms. High-throughput sequencing of representative plasmids (pCP40 and pEC86) led to the identification of 2 plasmids that shared the common backbone genes repA, DnaJ, StpA, and yafB, which were characteristic of the untypeable plasmid, and had similar blaKPC−2 genetic contexts of the Tn3-Tn4401 chimera. Nucleotide comparison revealed high sequence identity of the 2 plasmids with previously reported blaKPC−2-carrying untypeable plasmids. In particular, the pCP40 plasmid from C. portucalensis and the pHS062105-3 plasmid from K. pneumoniae differed by only 20 single-nucleotide polymorphisms (SNPs). To the best of our knowledge, this is the first report of a blaKPC-harboring untypeable plasmid spread into E. coli, E. asburiae, and C. koseri strains in China.

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“…A total of 13 carbapenemase-encoding genes, bla KPC , bla NDM , bla VIM , bla IMP , bla SME , bla GES , bla IMI , bla SIM , bla SPM , bla GIM , bla OXA-23 , bla OXA-24 and bla OXA-58 , from all the K. pneumoniae strains were amplified and sequenced [3,4,15,16]. The bla KPC genetic structures were detected by PCR as described in our previous study [8].…”

Section: Detection Of Resistance and Virulence Genesmentioning

confidence: 99%

Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses

Huang

Chen

Yang

et al. 2022

Journal of Medical Microbiology

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Introduction. Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of clinical infection. However, K. pneumoniae carbapenemase (KPC)-producing K. pneumoniae ST15 strains are occasionally identified and have seldom been reported to cause hospital outbreaks in PR China. Hypothesis/Gap Statement. In this study, we describe nosocomial outbreaks caused by KPC-producing K. pneumoniae ST15 strains in a Chinese tertiary hospital. Aim. To characterize the molecular relationship, resistance and virulence factors of the 32 KPC-producing K. pneumoniae ST15 strains isolated in a Chinese hospital. Methodology. A total of 102 non-repetitive carbapenem-resistant Enterobacteriaceae (CRE) strains were collected from a Chinese tertiary hospital in 2018. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were performed to characterize the clonal relationship of the K. pneumoniae isolates, and the ST15 strains were selected for further study. Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Fifteen carbapenem resistance genes, bla KPC genetic structures and 12 virulence factors were detected by PCR. Whole-genome sequencing (WGS) was performed using next-generation sequencing combined with single-molecule real-time sequencing. Results. Thirty-two K. pneumoniae ST15 strains were characterized, and 31 of them presented a PFGE similarity of >92 %, indicating clonal spread. In 81.3 % (26/32) of strains, the imipenem (IPM) and meropenem (MEM) MICs were ≤8 and≤16 µg ml−1, while only 1 isolate (KP18069) exhibited ≥64 µg ml−1 for both agents. The bla KPC-2 gene embedded in the Tn3-Tn4401 chimaera and synonymous mutations of the ompK35 gene were detected in all the strains. However, a nonsense mutation at amino acid position 248 (K248X) of OmpK36 was found in the highly carbapenem-resistant strain KP18069. No virulence gene was detected in any of the ST15 strains. WGS analyses further confirmed the genetic characteristics of the K. pneumoniae KP18069 strain. Conclusion. Nosocomial outbreaks caused by the clonal spread of K. pneumoniae ST15 strains were characterized in a Chinese tertiary hospital, and strict monitoring of highly resistant CRKP is required.

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Genetic characteristics of one highly multi-drug-resistant strain of Klebsiella ozaenae

Cited by 8 publications

References 17 publications

<p>Multi-Organ Abscesses and 5th Cervical Vertebra Bone Destruction Related with <em>Klebsiella ozaenae</em> Infection: A Case Report</p>

<p>Multi-Organ Abscesses and 5th Cervical Vertebra Bone Destruction Related with <em>Klebsiella ozaenae</em> Infection: A Case Report</p>

Further Spread of a blaKPC-Harboring Untypeable Plasmid in Enterobacteriaceae in China

Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses

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