Genomic Epidemiology and Characterization of Carbapenem-Resistant Klebsiella pneumoniae in ICU Inpatients in Henan Province, China: a Multicenter Cross-Sectional Study

Wang, Shanmei; Wang, Lei; Jin, Jing; Li, Gang; Shao, Hu; Song, Yang; Sun, Yi; Zhang, Yan; Cheng, Jian; Li, Lifeng

doi:10.1128/spectrum.04197-22

Microbiol Spectr

2023

DOI: 10.1128/spectrum.04197-22

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Genomic Epidemiology and Characterization of Carbapenem-Resistant Klebsiella pneumoniae in ICU Inpatients in Henan Province, China: a Multicenter Cross-Sectional Study

Shanmei Wang

Lei Wang

Jing Jin

et al.

Abstract: In this study, we address the ongoing epidemic of carbapenem-resistant Klebsiella pneumoniae , a critical threat to public health. The alarming genotypic and phenotypic convergence of multidrug resistance and virulence highlights the increasingly aggravated threat posed by K. pneumoniae .

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2024

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Cited by 2 publications

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Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae : a systematic review and meta-analysis

Namikawa,

Oinuma,

Kaneko

et al. 2024

Emerging Microbes & Infections

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Antimicrobial resistance has recently increased due to emerging carbapenem-resistant Klebsiella pneumoniae and extended-spectrum β-lactamase (ESBL)-producing strains of K. pneumoniae , especially among hypermucoviscous K. pneumoniae (hmKp) strains. To evaluate the prevalence of ESBL-producing and carbapenem-resistant strains in hmKp and non-hmKp clinical isolates through a systematic review and meta-analysis. We searched PubMed, Scopus, and Cochrane Library databases from January 2000 to June 2023. Clinical and in vivo/in vitro studies involving confirmed K. pneumoniae clinical isolates differentiated into hmKP and non-hmKP strains based on string test results. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated based on the number of individuals in each target group. Forest plots were used to visualize the effect sizes and 95% CIs of individual studies estimated using the inverse variance and DerSimonian – Laird methods with fixed – and random-effects models, respectively. Heterogeneity was assessed using Cochran’s Q test ( I 2 ≥ 50%). Fifteen studies comprising 2049 clinical isolates of K. pneumoniae met the inclusion criteria. Meta-analysis revealed that hmKp strains were associated with a significantly lower prevalence of ESBL-producing strains (pooled OR: 0.26, 95% CI: 0.11–0.63, P = 0.003) and a slightly lower prevalence of carbapenem-resistant strains than non-hmKp strains (pooled OR: 0.63, 95% CI: 0.40–0.97, P = 0.038). hmKp strains exhibited lower and slightly lower prevalence of ESBL production and carbapenem resistance, respectively, than non-hmKp strains. However, given the rising prevalence of ESBL-producing and carbapenem-resistant hmKp strains, patients infected by string-test-positive K. pneumoniae must be managed prudently, considering the potential for highly resistant strains.

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Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae : a systematic review and meta-analysis

Namikawa,

Oinuma,

Kaneko

et al. 2024

Emerging Microbes & Infections

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Global prevalence of mutation in the mgrB gene among clinical isolates of colistin-resistant Klebsiella pneumoniae: a systematic review and meta-analysis

Khoshbayan,

Narimisa,

Elahi

et al. 2024

Front. Microbiol.

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BackgroundColistin is used as a last resort for managing infections caused by multidrug-resistant bacteria. However, the high emergence of colistin-resistant strains has restricted the clinical use of this antibiotic in the clinical setting. In the present study, we evaluated the global prevalence of the mutation in the mgrB gene, one of the most important mechanisms of colistin resistance in Klebsiella pneumoniae.MethodsSeveral databases, including Scopus, Medline (via PubMed), and Web of Science, were searched (until August 2023) to identify those studies that address the mgrB mutation in clinical isolates of K. pneumoniae. Using Stata software, the pooled prevalence of mgrB mutation and subgroup analyses for the year of publication, country, continent, mgrB mutation types, and detection methods of mgrB mutation were analyzed.ResultsOut of the 115 studies included in the analysis, the prevalence of mgrB mutations in colistin-resistant K. pneumoniae isolates was estimated at 65% of isolates, and mgrB variations with insertional inactivation had the highest prevalence among the five investigated mutations with 69%. The year subgroup analysis indicated an increase in mutated mgrB from 46% in 2014 to 61% in 2022. Europe had the highest prevalence of mutated mgrB at 73%, while Africa had the lowest at 54%.ConclusionMutations in the mgrB gene are reported as one of the most common mechanisms of colistin resistance in K. pneumoniae, and the results of the present study showed that 65% of the reported colistin-resistant K. pneumoniae had a mutation in this gene.

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Genomic Epidemiology and Characterization of Carbapenem-Resistant Klebsiella pneumoniae in ICU Inpatients in Henan Province, China: a Multicenter Cross-Sectional Study

Abstract: In this study, we address the ongoing epidemic of carbapenem-resistant Klebsiella pneumoniae , a critical threat to public health. The alarming genotypic and phenotypic convergence of multidrug resistance and virulence highlights the increasingly aggravated threat posed by K. pneumoniae .

Cited by 2 publications

References 84 publications

Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae : a systematic review and meta-analysis

Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae : a systematic review and meta-analysis

Global prevalence of mutation in the mgrB gene among clinical isolates of colistin-resistant Klebsiella pneumoniae: a systematic review and meta-analysis

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