Molecular Epidemiology and Risk Factors of Carbapenem-Resistant Klebsiella Pneumoniae Bloodstream Infections in Wuhan, China

Lee, Chan; Liu, Lan; Jin, Ming-ming; Hu, Yangbo; Cai, Xuan; Wan, Li; Zhang, Hai-yue; Li, Rui-yun; Wu, Xiaojun

doi:10.1007/s11596-021-2480-5

Cited by 6 publications

(2 citation statements)

References 29 publications

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“…Multidrug-resistant bacteria (MDR) infections, featuring high incidence and fatality rates, are a threat to public health ( Liu et al, 2020 ; Yu et al, 2020 ; Mei et al, 2021 ). Among them, carbapenem-resistant Klebsiella pneumoniae (CRKP) has been listed as one of the most critical drug-resistant pathogens by the World Health Organization, because its carbapenemases product, capable of hydrolyzing and inactivating carbapenems and β-lactams antibiotics, can result in the dramatical infection occlusion in bloodstream, urinary tract, surgical-site, and lung ( Broberg et al, 2014 ; Escolà-Vergé et al, 2020 ; Mehrbakhsh et al, 2020 ; Han et al, 2022 ; Liu et al, 2022 ). To treat the bacterial infections, extensive efforts have been devoted and remarkable progresses have been made using various antibiotics ( Ji et al, 2021 ; Zong et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Eugenol eliminates carbapenem-resistant Klebsiella pneumoniae via reactive oxygen species mechanism

Liu

Chen²,

Dou³

et al. 2023

Front. Microbiol.

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Multidrug-resistant (MDR) bacterial infections have gained increasing attention due to the high incidence rates and high mortality, especially for the carbapenem-resistant Klebsiella pneumoniae (CRKP) infection that can cause severe complications (e.g., pneumonia and sepsis) in multiple organs. Therefore, the development of new antibacterial agents against CRKP is imperative. Inspired by natural plant antibacterial agents with broad-spectrum antibacterial properties, the antibacterial/biofilm activity of eugenol (EG) on CRKP and their underlying mechanisms are investigated in our work. It is found that EG exhibits remarkable inhibitory effects on planktonic CRKP in a dose-dependent fashion. Meanwhile, the destruction of membrane integrity induced by the formation of reactive oxygen species (ROS) and glutathione reduction results in the leakage of bacterial cytoplasmic components, including DNA, β-galactosidase, and protein. Moreover, when EG contacts with bacterial biofilm, the whole thickness of the dense biofilm matrix decreases, and the integrity is destroyed. Overall, this work verified that EG could eliminate CRKP via ROS-induced membrane rupture, which offers vital evidence to explain the antibacterial ability of EG against CRKP.

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Section: Introductionmentioning

confidence: 99%

Eugenol eliminates carbapenem-resistant Klebsiella pneumoniae via reactive oxygen species mechanism

Liu

Chen²,

Dou³

et al. 2023

Front. Microbiol.

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“…Klebsiella pneumoniae is a gram-negative, nonmotile, encapsulated opportunistic pathogen that generally colonises human mucous membranes, including the nasopharynx and gastrointestinal tract and is ubiquitously found in soils and the healthcare environment such as on the surfaces of medical devices [ 1 , 2 ]. In immunocompromised patients, infants and older adults, it can cause a variety of infectious diseases, including lower respiratory tract infections, urinary tract infections, bacteraemia and sepsis, and can even lead to infection-related death [ 3 – 5 ]. Furthermore, infection caused by drug-resistant K. pneumoniae , especially by carbapenem-resistant K. pneumoniae (CRKP), are known to be associated with longer hospital stays, higher medical costs and a higher risk of mortalities than those caused by carbapenem-susceptible K. pneumoniae [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and molecular characteristics of Klebsiella pneumoniae infection in a tertiary general hospital of Wuhan, China

Xiang,

Tian,

Chen

et al. 2023

Eur J Clin Microbiol Infect Dis

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Objectives The aim of this study was to investigate the clinical and molecular characteristics of Klebsiella pneumoniae infection from a tertiary general hospital in Wuhan, China. Methods From December 2019 to August 2022, 311 non-duplicate isolates of K. pneumoniae were collected from a tertiary hospital in Wuhan. These comprised 140 carbapenem-resistant K. pneumoniae (CRKP) isolates and 171 carbapenem-susceptible K. pneumoniae (CSKP) isolates. The clinical characteristics of patients with K. pneumoniae infection were retrospectively collected. Polymerase chain reaction (PCR) assays were used to identify the main carbapenem resistance genes, virulence genes and multi-locus sequence typing (MLST) profiles of the isolates, and the Galleria mellonella infection model was used to determine their virulence phenotypes. Results Independent risk factors for CRKP infection were hypertension, neurological disorders, being admitted to the intensive care unit (ICU) and prior use of antibiotics. Patient with CRKP infection had higher mortality than those with CSKP infection (23.6% vs 14.0%, P < 0.05). One hundred and two sequence types (STs) were identified among the K. pneumoniae isolates, and the most prevalent ST type was ST11 (112/311, 36.0%). All of the ST11 isolates were CRKP. Among the 112 ST11 isolates, 105 (93.8%) harboured the carbapenem resistance gene blaKPC-2 (ST11-KPC-2), and of these isolates, 78 (74.3%, 78/105) contained all of the four virulence genes, namely rmpA, rmpA2, iroN and iucA, suggesting that these genes were widespread among the isolates responsible for K. pneumoniae infections. Conclusion In this study, ST11-KPC-2 was responsible for most of the K. pneumoniae infection cases. Carbapenem resistance rather than the co-occurrence of the virulence genes rmpA, rmpA2, iroN and iucA was associated with K. pneumoniae infection-related mortality during hospitalisation. Furthermore, a high proportion of ST11-KPC-2 isolates carried all of the four virulence genes.

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Relationship between antibiotic exposure and carbapenem-resistant Klebsiella pneumoniae infection within four types of control patients: A systematic review and meta-analysis

Zhu¹,

Liang²,

Hui³

et al. 2023

Journal of Global Antimicrobial Resistance

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Molecular Epidemiology and Risk Factors of Carbapenem-Resistant Klebsiella Pneumoniae Bloodstream Infections in Wuhan, China

Cited by 6 publications

References 29 publications

Eugenol eliminates carbapenem-resistant Klebsiella pneumoniae via reactive oxygen species mechanism

Eugenol eliminates carbapenem-resistant Klebsiella pneumoniae via reactive oxygen species mechanism

Clinical and molecular characteristics of Klebsiella pneumoniae infection in a tertiary general hospital of Wuhan, China

Relationship between antibiotic exposure and carbapenem-resistant Klebsiella pneumoniae infection within four types of control patients: A systematic review and meta-analysis

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