&lt;p&gt;Carbapenem-Resistant &lt;em&gt;Klebsiella aerogenes&lt;/em&gt; Clinical Isolates from a Teaching Hospital in Southwestern China: Detailed Molecular Epidemiology, Resistance Determinants, Risk Factors and Clinical Outcomes&lt;/p&gt;

Ma, Deyu; Huang, Hanyu; Zhang, Hua; Wu, Minghui; Lin, Qiuxia; Liu, Bo; Huang, Shifeng

doi:10.2147/idr.s235975

Cited by 10 publications

(9 citation statements)

References 21 publications

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“…Out of the 10 isolates, we discovered that two only contained the bla KPC-2 gene and three only contained the bla NDM-1 gene while, interestingly, five strains carried both the bla KPC-2 and bla NDM-1 genes. Previous studies have reported the presence of bla KPC or bla NDM genes in clinical K. aerogenes isolates from various countries ( Pulcrano et al, 2016 ; Franolić et al, 2019 ; Ma et al, 2020 ), including Brazil ( Bispo Beltrão et al, 2020 ; Soares et al, 2021 ). However, our literature review indicated that there has been only one study of K. aerogenes co-harboring both bla KPC and bla NDM genes, which was observed in China ( Zhang et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

“…The presence of ESBLs in K. aerogenes strains has been well-documented, leading to the use of carbapenems as a last-resort treatment for serious infections caused by these pathogens. However, previous studies have shown a high prevalence of antibiotic resistance to cephalosporins and carbapenems in clinically relevant K. aerogenes strains worldwide ( Ma et al, 2020 ). These infections pose a significant public health challenge due to the limited treatment options available and their elevated mortality rates ( Mulani et al, 2019 ; Denissen et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

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First report of coexistence of blaKPC-2 and blaNDM-1 in carbapenem-resistant clinical isolates of Klebsiella aerogenes in Brazil

Rodrigues,

Nunes,

Soares

et al. 2024

Front. Microbiol.

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Klebsiella aerogenes is an important opportunistic pathogen with the potential to develop resistance against last-line antibiotics, such as carbapenems, limiting the treatment options. Here, we investigated the antibiotic resistance profiles of 10 K. aerogenes strains isolated from patient samples in the intensive-care unit of a Brazilian tertiary hospital using conventional PCR and a comprehensive genomic characterization of a specific K. aerogenes strain (CRK317) carrying both the blaKPC-2 and blaNDM-1 genes simultaneously. All isolates were completely resistant to β-lactam antibiotics, including ertapenem, imipenem, and meropenem with differencing levels of resistance to aminoglycosides, quinolones, and tigecycline also observed. Half of the strains studied were classified as multidrug-resistant. The carbapenemase-producing isolates carried many genes of interest including: β-lactams (blaNDM-1, blaKPC-2, blaTEM-1, blaCTX-M-1 group, blaOXA-1 group and blaSHVvariants in 20-80% of the strains), aminoglycoside resistance genes [aac(6’)-Ib and aph(3’)-VI, 70 and 80%], a fluoroquinolone resistance gene (qnrS, 80%), a sulfonamide resistance gene (sul-2, 80%) and a multidrug efflux system transporter (mdtK, 70%) while all strains carried the efflux pumps Acr (subunit A) and tolC. Moreover, we performed a comprehensive genomic characterization of a specific K. aerogenes strain (CRK317) carrying both the blaKPC-2 and blaNDM-1 genes simultaneously. The draft genome assembly of the CRK317 had a total length of 5,462,831 bp and a GC content of 54.8%. The chromosome was found to contain many essential genes. In silico analysis identified many genes associated with resistance phenotypes, including β-lactamases (blaOXA-9, blaTEM-1, blaNDM-1, blaCTX-M-15, blaAmpC-1, blaAmpC-2), the bleomycin resistance gene (bleMBL), an erythromycin resistance methylase (ermC), aminoglycoside-modifying enzymes [aac(6’)-Ib, aadA/ant(3”)-Ia, aph(3’)-VI], a sulfonamide resistance enzyme (sul-2), a chloramphenicol acetyltransferase (catA-like), a plasmid-mediated quinolone resistance protein (qnrS1), a glutathione transferase (fosA), PEtN transferases (eptA, eptB) and a glycosyltransferase (arnT). We also detected 22 genomic islands, eight families of insertion sequences, two putative integrative and conjugative elements with a type IV secretion system, and eight prophage regions. This suggests the significant involvement of these genetic structures in the dissemination of antibiotic resistance. The results of our study show that the emergence of carbapenemase-producing K. aerogenes, co-harboring blaKPC-2 and blaNDM-1, is a worrying phenomenon which highlights the importance of developing strategies to detect, prevent, and control the spread of these microorganisms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

First report of coexistence of blaKPC-2 and blaNDM-1 in carbapenem-resistant clinical isolates of Klebsiella aerogenes in Brazil

Rodrigues,

Nunes,

Soares

et al. 2024

Front. Microbiol.

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“…K. aerogenes isolates that harbor an extended range of beta-lactamase and carbapenemase genes and such strains are frequently associated with hospital outbreaks [15]. Recent research suggests that carbapenem resistance in K. aerogenes is mostly caused by overexpression of ESBLs and ampC enzymes harbored by efflux pumps and efflux pump inhibitors (EPIs) [16].…”

Section: Introductionmentioning

confidence: 99%

Development of a Candidate Multi-Epitope Subunit Vaccine against Klebsiella aerogenes: Subtractive Proteomics and Immuno-Informatics Approach

et al. 2021

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Klebsiella aerogenes is a Gram-negative bacterium which has gained considerable importance in recent years. It is involved in 10% of nosocomial and community-acquired urinary tract infections and 12% of hospital-acquired pneumonia. This organism has an intrinsic ability to produce inducible chromosomal AmpC beta-lactamases, which confer high resistance. The drug resistance in K. aerogenes has been reported in China, Israel, Poland, Italy and the United States, with a high mortality rate (~50%). This study aims to combine immunological approaches with molecular docking approaches for three highly antigenic proteins to design vaccines against K. aerogenes. The synthesis of the B-cell, T-cell (CTL and HTL) and IFN-γ epitopes of the targeted proteins was performed and most conserved epitopes were chosen for future research studies. The vaccine was predicted by connecting the respective epitopes, i.e., B cells, CTL and HTL with KK, AAY and GPGPG linkers and all these were connected with N-terminal adjuvants with EAAAK linker. The humoral response of the constructed vaccine was measured through IFN-γ and B-cell epitopes. Before being used as vaccine candidate, all identified B-cell, HTL and CTL epitopes were tested for antigenicity, allergenicity and toxicity to check the safety profiles of our vaccine. To find out the compatibility of constructed vaccine with receptors, MHC-I, followed by MHC-II and TLR4 receptors, was docked with the vaccine. Lastly, in order to precisely certify the proper expression and integrity of our construct, in silico cloning was carried out. Further studies are needed to confirm the safety features and immunogenicity of the vaccine.

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“…It is widely associated with bloodstream, skin and soft tissue, respiratory, and urinary tract infections [16]. Recently, the emergence of carbapenem-resistant K. aerogenes and colistin-resistant K. aerogenes isolates in China is of concern [17][18][19][20]. However, the genetic background of K. aerogenes isolates recovered from clinical settings in China remains largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Comparative Genomic Analysis and Phenotypic Characterization of Bronchoscope-Associated Klebsiella Aerogenes

Huang

Chi

et al. 2020

Preprint

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Background: Bronchoscopes has been linked to the outbreaks of nosocomial infections. We aim to investigate the phenotypic and genomic profiles of bronchoscope-associated Klebsiella aerogenes isolates, and their association with genome public available isolates from human and environment.Methods: We performed a prospective single-center study sampling echoendoscopes after clinical use and after normal decontamination procedures. Bacterial screening was conducted by culturing the sample on Mueller-Hinton agar plates. Antimicrobial susceptibility testing was performed using the broth microdilution method. Whole-genome sequencing of K. aerogenes isolates was performed using an Illumina HiSeq system and comparative genomics analysis were conducted.Results: Over the 5-month period, a total of 358 isolates and 13 isolates were recovered from samples after clinical procedures and samples after decontamination procedures, respectively. Antimicrobial susceptibility testing found 7 K. aerogenes isolates to exhibit low-level resistance to antimicrobial agents. Among 7 K. aerogenes isolates, we found 5 sequence types (STs). Whole genome sequencing and comparison analysis observed the genetic diversity in our bacterial collection, which clustered into three main clades. Furthermore, we identified a total of 43 antimicrobial resistance genes in the K. aerogenes core genomes. As expected, human isolates encoded more antimicrobial resistance genes than that environmental isolates. Conclusions: This study first described the phenotypic and genomics characteristics of bronchoscope-associated K. aerogenes. The present observations demonstrated that broadly investigation of specific pathogens using publicly available global genomes offered the opportunity to identify prevalent clones associated with various hosts, sources, and geographical locations.

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<p>Carbapenem-Resistant <em>Klebsiella aerogenes</em> Clinical Isolates from a Teaching Hospital in Southwestern China: Detailed Molecular Epidemiology, Resistance Determinants, Risk Factors and Clinical Outcomes</p>

Cited by 10 publications

References 21 publications

First report of coexistence of blaKPC-2 and blaNDM-1 in carbapenem-resistant clinical isolates of Klebsiella aerogenes in Brazil

First report of coexistence of blaKPC-2 and blaNDM-1 in carbapenem-resistant clinical isolates of Klebsiella aerogenes in Brazil

Development of a Candidate Multi-Epitope Subunit Vaccine against Klebsiella aerogenes: Subtractive Proteomics and Immuno-Informatics Approach

Comparative Genomic Analysis and Phenotypic Characterization of Bronchoscope-Associated Klebsiella Aerogenes

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