Molecular Characterization of Carbapenem Resistant Klebsiella pneumoniae and Klebsiella quasipneumoniae Isolated from Lebanon

Abstract

Klebsiella pneumoniae is a Gram-negative organism and a major public health threat. In this study, we used whole-genome sequences to characterize 32 carbapenem-resistant K. pneumoniae (CRKP) and two carbapenem-resistant K. quasipneumoniae (CRKQ). Antimicrobial resistance was assessed using disk diffusion and E-test, while virulence was assessed in silico. The capsule type was determined by sequencing the wzi gene. The plasmid diversity was assessed by PCR-based replicon typing to detect the plasmid incompatibility (Inc) groups. The genetic relatedness was determined by multilocus sequence typing, pan-genome, and recombination analysis. All of the isolates were resistant to ertapenem together with imipenem and/or meropenem. Phenotypic resistance was due to blaOXA-48, blaNDM-1, blaNDM-7, or the coupling of ESBLs and outer membrane porin modifications. This is the first comprehensive study reporting on the WGS of CRKP and the first detection of CRKQ in the region. The presence and dissemination of CRKP and CRKQ, with some additionally having characteristics of hypervirulent clones such as the hypermucoviscous phenotype and the capsular type K2, are particularly concerning. Additionally, mining the completely sequenced K. pneumoniae genomes revealed the key roles of mobile genetic elements in the spread of antibiotic resistance and in understanding the epidemiology of these clinically significant pathogens.

Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

“…The results shown in Table 1 indicate that in Lebanon, during 2020 through 2020, resistance to 3rd- and 4th-generation cephalosporins, such as cefotaxime, ceftazidime, and cefepime, aminoglycosides, e.g., gentamicin and amikacin, ciprofloxacin—a quinolone drug—and carbapenems, such as imipenem and meropenem, was higher. Curiously, resistance to piperacillin-tazobactam was relatively lower [ 77 , 78 , 79 , 80 ]. The increasing antibiotic resistance trends in Lebanon were justified by characterization of β-lactamase phenotypic and genotypic activities.…”

“…Molecular analysis carried with PCR, shown in Table 2 indicated that bla SHV , bla TEM and bla CTX-M were the most predominant ESBL-encoding genes among E. coli and ESKAPE pathogens, this increasing trend was also observed for bla OXA , and bla GES ESBL traits. On the other hand, bla VIM was the most common metallo-β-lactamass resistance encoding gene which showed remarkable increase, with fewer isolates shown to express the bla NDM ESBL trait [ 77 , 78 , 79 , 80 , 81 ].…”

<p>Carbapenem-Resistant <em>Enterobacter cloacae</em> Causing Nosocomial Infections in Southwestern China: Molecular Epidemiology, Risk Factors, and Predictors of Mortality</p>

“…However, the molecular epidemiological characteristics of CR-ECL infection are different from region to region. 13,14 In this study, we attempted to systematically analyse the epidemiological characteristics of CR-ECL infection to provide evidence for effective control of nosocomial infection with CR-ECL.…”

Exploring the phenotype and genotype of multi-drug resistant Klebsiella pneumoniae harbouring blaCTX-M group extended-spectrum β-lactamases recovered from paediatric clinical cases in Shenzhen, China

“…We first report the high presence of co-existing carbapenem-resistant genes bla KPC-2 (71%), bla NDM-1 (25%) with ESBLs encoding gene in Shenzhen, China as well co-existence of carbapenem resistance genes in ESBLs-producing K. pneumoniae has flagged concern about the spread of such superbugs in the Shenzhen area. Several reports have shown the co-existence of carbapenem resistance genes and ESBLs encoding genes in K. pneumoniae on a global scale [21]. Our MLST results demonstrated that ST20 and ST2407 were highly prominent in Shenzhen area which encodes ESBLs genes.…”