Klebsiella pneumoniae: Virulence, Biofilm and Antimicrobial Resistance

Piperaki, Evangelia-Theophano; Syrogiannopoulos, George A.; Tzouvelekis, L. S.; Daikos, George L.

doi:10.1097/inf.0000000000001675

Cited by 123 publications

(108 citation statements)

References 29 publications

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“…pneumoniae is able to form bio lms, and these adherent cells are often embedded within a self-produced matrix of extracellular polymeric substance. Bio lms are most notorious for high-level resistance to antibiotics [18]. erapies for bio lm infections remain very di cult, and successful cases are quite rare.…”

Section: Discussionmentioning

confidence: 99%

Low-Frequency Ultrasound Enhances Bactericidal Activity of Antimicrobial Agents against Klebsiella pneumoniae Biofilm

Liu

Wang

Weng³

et al. 2020

BioMed Research International

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Klebsiella pneumoniae biofilms on inserted devices have been proposed as one of the important factors for hospital-acquired infections, which cause increased resistance to currently used antibiotics. Therefore, it is urgently necessary to develop new treatments with more efficient bacterial clearance. In the present study, we aimed at investigating whether low-frequency ultrasound (LFU) could enhance the bactericidal activity of antimicrobial agents (meropenem (MEM), tigecycline (TGC), fosfomycin (FOM), amikacin (AMK), and colistin (COL)) against K. pneumoniae biofilm infection. K. pneumoniae biofilm was cultivated on the catheter in vitro. Synergistic effects were observed in groups of single ultrasound (S-LFU, 5 min) or multiple ultrasound (M-LFU, 5 min every 8 h (q8h)) in combination with MEM, TGC, and FOM. However, AMK and COL did not show the synergistic effect with either S-LFU or M-LFU. S-LFU in combination with FOM only significantly decreased bacterial counts right after ultrasound, while M-LFU could prolong the synergistic effect until 24 h. The results showed that LFU in combination with antimicrobial agents had a synergistic effect on K. pneumoniae biofilm, and M-LFU might extend the time of synergistic effect compared with S-LFU.

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Section: Discussionmentioning

confidence: 99%

Low-Frequency Ultrasound Enhances Bactericidal Activity of Antimicrobial Agents against Klebsiella pneumoniae Biofilm

Liu

Wang

Weng³

et al. 2020

BioMed Research International

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“…Recently, it has emerged globally as a multidrug-resistant hospital pathogen for which there are few treatment options (Paczosa and Mecsas, 2016). The investigations about its virulence factors have added newer insights to its self-protective pathogenic strategies, which comprise mainly of fimbriae, capsule, and lipopolysaccharide responsible for attachment to host surface, protection against phagocytosis, desiccation, and complement evasion, respectively (Victor et al, 2007; El Fertas-Aissani et al, 2013; Piperaki et al, 2017). Besides, type 1 and type 3 fimbriae are revealed to arbitrate its colonization on passive/inert abiotic surfaces (Murphy and Clegg, 2012; Murphy et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Classification of Clinical Isolates of Klebsiella pneumoniae Based on Their in vitro Biofilm Forming Capabilities and Elucidation of the Biofilm Matrix Chemistry With Special Reference to the Protein Content

et al. 2019

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Klebsiella pneumoniae is a human pathogen, capable of forming biofilms on abiotic and biotic surfaces. The limitations of the therapeutic options against Klebsiella pneumoniae is actually due to its innate capabilities to form biofilm and harboring determinants of multidrug resistance. We utilized a newer approach for classification of biofilm producing Klebsiella pneumoniae isolates and subsequently we evaluated the chemistry of its slime, more accurately its biofilm. We extracted and determined the amount of polysaccharides and proteins from representative bacterial biofilms. The spatial distribution of sugars and proteins were then investigated in the biofilm matrix using confocal laser scanning microscopy (CLSM). Thereafter, the extracted matrix components were subjected to sophisticated analysis incorporating Fourier transform infrared (FTIR) spectroscopy, nuclear magnetic resonance (NMR) spectroscopy, one-dimensional gel-based electrophoresis (SDS-PAGE), high performance liquid chromatography (HPLC), and MALDI MS/MS analysis. Besides, the quantification of its total proteins, total sugars, uronates, total acetyl content was also done. Results suggest sugars are not the only/major constituent of its biofilms. The proteins were harvested and subjected to SDS-PAGE which revealed various common and unique protein bands. The common band was excised and analyzed by HPLC. MALDI MS/MS results of this common protein band indicated the presence of different proteins within the biofilm. The 55 different proteins were identified including both cytosolic and membrane proteins. About 22 proteins were related to protein synthesis and processing while 15 proteins were identified related to virulence. Similarly, proteins related to energy and metabolism were 8 and those related to capsule and cell wall synthesis were 4. These results will improve our understanding of Klebsiella biofilm composition and will further help us design better strategies for controlling its biofilm such as techniques focused on weakening/targeting certain portions of the slime which is the most common building block of the biofilm matrix.

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“…pneumoniae is a serious problem and only a few remaining last-resort antibiotics can be used to treat fluoroquinolones and carbapenem-resistant K . pneumoniae (CRKP) infections 14,15 . The worldwide spread of Klebsiella pneumoniae spp., resistant to a variety of antibiotics, threatens to revert modern medicine to a pre-antibiotic era.…”

Section: Introductionmentioning

confidence: 99%

Complete genome analysis of a Siphoviridae phage TSK1 showing biofilm removal potential against Klebsiella pneumoniae

Tabassum

Shafique

Khawaja

et al. 2018

Sci Rep

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Multidrug-resistant Klebsiella pneumoniae is a nosocomial pathogen, produces septicemia, pneumonia and UTI. Excessive use of antibiotics contributes towards emergence of multidrug-resistance. Bacteriophage-therapy is a potential substitute of antibiotics with many advantages. In this investigation, microbiological and genome characterization of TSK1 bacteriophage and its biofilm elimination capability are presented. TSK1 showed narrow host range and highest stability at pH 7 and 37 °C. TSK1 reduced the growth of K. pneumoniae during the initial 14 hours of infection. Post-treatment with TSK1 against different age K. pneumoniae biofilms reduced 85–100% biomass. Pre-treatment of TSK1 bacteriophage against the biofilm of Klebsiella pneumoniae reduced > 99% biomass in initial 24 hr of incubation. The genome of TSK1 phage comprised 49,836 base pairs with GC composition of 50.44%. Total seventy-five open reading frames (ORFs) were predicted, 25 showed homology with known functional proteins, while 50 were called hypothetical, as no homologs with proved function exists in the genome databases. Blast and phylogenetic analysis put it in the Kp36 virus genus of family Siphoviridae. Proposed packaging strategy of TSK1 bacteriophage genome is headful packaging using the pac sites. The potential of TSK1 bacteriophage could be used to reduce the bacterial load and biofilm in clinical and non-clinical settings.

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Klebsiella pneumoniae: Virulence, Biofilm and Antimicrobial Resistance

Cited by 123 publications

References 29 publications

Low-Frequency Ultrasound Enhances Bactericidal Activity of Antimicrobial Agents against Klebsiella pneumoniae Biofilm

Low-Frequency Ultrasound Enhances Bactericidal Activity of Antimicrobial Agents against Klebsiella pneumoniae Biofilm

Classification of Clinical Isolates of Klebsiella pneumoniae Based on Their in vitro Biofilm Forming Capabilities and Elucidation of the Biofilm Matrix Chemistry With Special Reference to the Protein Content

Complete genome analysis of a Siphoviridae phage TSK1 showing biofilm removal potential against Klebsiella pneumoniae

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