Heat-resistant, extended-spectrum β-lactamase-producing Klebsiella pneumoniae in endoscope-mediated outbreak

Jørgensen, Silje Bakken; Bojer, Martin Saxtorph; Boll, Erik J.; Martin, Y.; Helmersen, Karin; Skogstad, M.; Struve, Carsten

doi:10.1016/j.jhin.2016.01.014

Cited by 39 publications

(21 citation statements)

References 13 publications

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“…ClpG/ ClpG GI might have developed in bacteria indwelling a demanding ecological niche in parallel to the Hsp70-ClpB system, or ClpG/ ClpG GI is an evolutionary younger protein. Recent acquisition of ClpG GI homologs, often on plasmids and in more than one copy, by unconventional pathogens associated with industrial and clinical settings (see also below) suggests that certain man-made environments provide a strong selection pressure aiding predominantly the spread of the dna-shsp20 GI -clpG GI core unit (59,60).…”

Section: Discussionmentioning

confidence: 99%

Stand-alone ClpG disaggregase confers superior heat tolerance to bacteria

Lee

Franke

Kamal

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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AAA+ disaggregases solubilize aggregated proteins and confer heat tolerance to cells. Their disaggregation activities crucially depend on partner proteins, which target the AAA+ disaggregases to protein aggregates while concurrently stimulating their ATPase activities. Here, we report on two potent ClpG disaggregase homologs acquired through horizontal gene transfer by the species and subsequently abundant clone C. ClpG exhibits high, stand-alone disaggregation potential without involving any partner cooperation. Specific molecular features, including high basal ATPase activity, a unique aggregate binding domain, and almost exclusive expression in stationary phase distinguish ClpG from other AAA+ disaggregases. Consequently, ClpG largely contributes to heat tolerance of primarily in stationary phase and boosts heat resistance 100-fold when expressed in This qualifies ClpG as a potential persistence and virulence factor in .

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Section: Discussionmentioning

confidence: 99%

Stand-alone ClpG disaggregase confers superior heat tolerance to bacteria

Lee

Franke

Kamal

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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“…However, there are often situations where this is not feasible, both in food production and in the medical field, and lower temperatures must be employed. This is the case for heat treatment of flexible endoscopes (where thermochemical treatment below 60°C is being used; Jørgensen et al, 2016) or in case of thermization of raw milk for the production of specific cheeses (57–68°C for 15 s or more; Peng et al, 2013a), where protection of certain enzymes is aimed for. These treatments are generally sufficient to reduce the vegetative bacterial load to safe levels, unless the contaminating bacteria are especially heat-resistant.…”

Section: Introductionmentioning

confidence: 99%

Turn Up the Heat—Food and Clinical Escherichia coli Isolates Feature Two Transferrable Loci of Heat Resistance

et al. 2017

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Heat treatment is a widely used process to reduce bacterial loads in the food industry or to decontaminate surfaces, e.g., in hospital settings. However, there are situations where lower temperatures must be employed, for instance in case of food production such as raw milk cheese or for decontamination of medical devices such as thermo-labile flexible endoscopes. A recently identified locus of heat resistance (LHR) has been shown to be present in and confer heat resistance to a variety of Enterobacteriaceae, including Escherichia coli isolates from food production settings and clinical ESBL-producing E. coli isolates. Here, we describe the presence of two distinct LHR variants within a particularly heat resistant E. coli raw milk cheese isolate. We demonstrate for the first time in this species the presence of one of these LHRs on a plasmid, designated pFAM21805, also encoding type 3 fimbriae and three bacteriocins and corresponding self-immunity proteins. The plasmid was highly transferable to other E. coli strains, including Shiga-toxin-producing strains, and conferred LHR-dependent heat resistance as well as type 3 fimbriae-dependent biofilm formation capabilities. Selection for and acquisition of this “survival” plasmid by pathogenic organisms, e.g., in food production environments, may pose great concern and emphasizes the need to screen for the presence of LHR genes in isolates.

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“…3 (length of <15 kb only is shown). (19,20). In our study, infection control practitioners took samples from incubators, air, the hands of doctors and nurses, objects and patient skin for bacterial culture.…”

Section: Pathogen-host Interactions and Genomic Islandsmentioning

confidence: 99%

Co-outbreak of ST37 and a novel ST3006 Klebsiella pneumoniae from multi-site infection in a neonatal intensive care unit: a retrospective study

Chen

et al. 2018

Preprint

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21 sequencing; Neonatal intensive care unit 22 23 2 Summary 24 Background: The spread of carbapenem resistance among Klebsiella pneumoniae (K. 25 pneumoniae) is a major public health problem, particularly in neonatal intensive care 26 units (NICUs).27Aim: To describe the nosocomial co-outbreak of ST37 and a new sequence type 28 ST3006 K. pneumoniae, causing catheter-related bloodstream infections in NICU. 29Methods: Fifteen strains of K. pneumoniae were isolated from seven neonates during 30 June 3-28, 2013, in a tertiary hospital neonatal intensive care unit in Fujian, China. 31Antimicrobial susceptibility was determined by the Vitek 2 system and micro-broth 32 dilution method. Multi-locus sequence typing (MLST) and pulsed-field gel 33 electrophoresis (PFGE) were used to analyse the genetic relatedness of isolates. 34Genome sequencing and gene function analyses were performed for investigating 35 pathogenicity and drug resistance and screening genomic islands. 36Findings: Two K. pneumoniae clones were identified from seven neonates with 37 multi-site infection, one ST37 strain and one new sequence type ST3006. 38Antimicrobial susceptibility testing revealed that the ST37 strain exhibited multi-drug 39 resistance and carbapenem resistance. The ST3006 strain was only resistant to 40 ampicillin-sulbactam, cefazolin, ceftriaxone. MLST and PFGE showed that 15 strains 41 were divided into three groups, with a high level of homology. Gene sequencing and 42 analysis indicated that KPN1343 harboured 12 resistance genes, 15 genomic islands 43 and 205 reduced virulence genes. KPN1344 harboured four resistance genes, 19 44 genomic islands and 209 reduced virulence genes. 45 Conclusion: Co-outbreak of K. pneumoniae involved two clones, ST36 and ST3006, 46 causing multi-site infection. Genome sequencing and analysis is an effective method 47 for studying bacterial resistance genes and their functions.48 49 50 Introduction 51 Klebsiella pneumonia, particularly multidrug resistant K. pneumoniae, is a 52 common and important pathogen in hospitals, posing a serious and urgent threat to 53 public health (1, 2). Neonates in the neonatal intensive care units often have 54 underlying conditions, such as prematurity, or the presence of indwelling catheters, a 55 history of antibiotic treatment and parenteral nutrition, which are risk factors for 56 infection (3). In addition, relaxed vigilance by doctors and nurses regarding 57 nosocomial infection promotes nosocomial infection outbreaks, with considerable 58 impact on neonatal treatment and prognosis, prolonged hospital stays, increased 59 hospital costs and mortality. 60 Nosocomial outbreaks in the neonatal intensive care unit are frequently reported 61(4-7); however, it is rare to isolate the same clonal pathogen from different sites in the 62 same patient. This study identified 15 K. pneumoniae strains isolated from sputum 63 specimens, blood specimens and umbilical vein catheter tips in seven neonates that 64 belonged to the two cloned strains ST37 and ST3006, which produced carb...

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Heat-resistant, extended-spectrum β-lactamase-producing Klebsiella pneumoniae in endoscope-mediated outbreak

Cited by 39 publications

References 13 publications

Stand-alone ClpG disaggregase confers superior heat tolerance to bacteria

Stand-alone ClpG disaggregase confers superior heat tolerance to bacteria

Turn Up the Heat—Food and Clinical Escherichia coli Isolates Feature Two Transferrable Loci of Heat Resistance

Co-outbreak of ST37 and a novel ST3006 Klebsiella pneumoniae from multi-site infection in a neonatal intensive care unit: a retrospective study

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