Spreading of extended-spectrum β-lactamase-producing Escherichia coli ST131 and Klebsiella pneumoniae ST11 in patients with pneumonia

Liu, Jing; Du, Shuaixian; Zhang, J; Liu, Shihan; Zhou, Yaya; Wang, Xiaorong

doi:10.1097/cm9.0000000000000368

Cited by 20 publications

(15 citation statements)

References 58 publications

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“…Despite the fact that TEM and SHV variants are the most universal ESBLs, it seems that they have become less common over the past decade than CTX-M. The results of this study were consistent with previous studies that found the bla CTX-M gene as the most widespread ESBL type in K. pneumoniae isolates 16,17,25 . However, Ferreira et al 10 from Brazil and Carvalho et al 18 from Portugal showed a higher prevalence of bla SHV compared to bla CTX-M in K. pneumoniae, which was in contrast to our finding.…”

Section: Discussionsupporting

confidence: 90%

Extended-spectrum beta-lactamases among Klebsiella pneumoniae from Iraqi patients with community-acquired pneumonia

Raouf

Benyagoub

Alkhudhairy³

et al. 2022

Rev. Assoc. Med. Bras.

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OBJECTIVE: Beta-lactams resistance is a major clinical problem in treating pneumonia. This study aimed to detect the extended-spectrum betalactamases (ESBL) genes in Klebsiella pneumoniae among patients with community-acquired pneumonia (CAP) in Al-Najaf City, Iraq. METHODS: A total of 511 sputum samples were obtained from all suspected patients with CAP in Al-Najaf City, Iraq, from March 2020 to September 2020. Sputum samples were subjected to microbiological tests. The disk diffusion method was used to test antibiotic sensitivity. Production of ESBLs was identified using phenotypic and genotypic methods. RESULTS: The total prevalence of K. pneumoniae was 31.9% (163/511). Using CHROM agar, 41 (25.2%) isolates were ESBL producers. The imipenem 0.0% (n=0/41) and norfloxacin 0.0% (n=0/41) were the most effective antibiotics. The multiplex polymerase chain reaction showed that 46.3% (n=19/41) of isolates harbored ESBL genes. Out of 19 ESBL producers, 47.4% and 15.8% harbored bla CTX-M and bla SHV , respectively. While bla CTX-M and bla SHV genes were detected in 7 (36.8%) isolates, simultaneously. CONCLUSIONS: The imipenem and norfloxacin can be used in empirical treatment of K. pneumoniae isolates in Iraq. The emergence of K. pneumoniae strains harboring ESBL resistance genes necessitates the development of a regular surveillance program to prevent the spreading of these isolates more in Iraqi health care systems.

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Section: Discussionsupporting

confidence: 90%

Extended-spectrum beta-lactamases among Klebsiella pneumoniae from Iraqi patients with community-acquired pneumonia

Raouf

Benyagoub

Alkhudhairy³

et al. 2022

Rev. Assoc. Med. Bras.

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“…ST11 international high-risk clone, the most prevalent sequence type in this collection, has been described in outbreaks of ESBL-producing K. pneumoniae in some countries such as Iran, China, Sweden and detected in a OXA-48-producing isolates from Iran and Spain [2,11,22,23]. In our study, ST11 co-carried multiple resistance determinants such as bla CTX−M−15, bla TEM , bla SHV and PMQR genes including qnrB, qnrS, oqxA, oqxB and aac(6)-Ib-cr, that correlates well with earlier reports as the dominant global ESBLs are the CTX-M type beta-lactamases in K. pneumoniae [2,22]. The presence of quinolone resistance genes aac(6′)Ib-cr and qnrB was recently reported in ST11 K. pneumoniae strains from Colombia [24].…”

Section: Discussionmentioning

confidence: 95%

Molecular characterization of plasmid-mediated quinolone resistance (PMQR) and ESBLs-producing Klebsiella pneumonia isolated from an Iranian teaching hospital

Talebzadeh

Mellali

Solgi

2021

Preprint

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Background The spread of plasmid-mediated multidrug resistance in Klebsiella pneumonia is a serious threat to the public health. We investigated the clinical characteristics and molecular epidemiology of K. pneumoniae isolated at a teaching hospital in Iran. Methods A total of 50 third-generation cephalosporins resistant K. pneumoniae strains were collected from patients’ clinical cultures. Antibiotic susceptibility testing and determination of MIC values for ceftazidime, cefotaxime and ciprofloxacin were performed. PCR and DNA sequencing were used to assess the presence of ESBL genes (blaCTX−M, blaTEM, blaSHV) and PMQR genes (qnrA, qnrB, qnrS, qepA, oqxA, oqxB and aac(6)-Ib-cr). Multilocus sequence typing (MLST) was performed on the strains to assess homology. Results Our results showed that the rates of resistance to all of antibiotics is high. All 50 K. pneumoniae strains harboured at least one of the ESBL resistance determinants. The blaCTX−M−15 gene was the major ESBLs determinant found in K. pneumoniae (88%; 44/50). PMQR was detected in 96% of the isolates and aac(6′)-Ib-cr was the most common (78% 39/50) followed by oqxA 36 (72%), oqxB 34 (68%), qnrS 20 (40%), qnrB 14 (28%) and qepA 1 (2%). MLST identified seven sequence types (STs), with the most common being ST11 (19/39). There was a strong association between PMQR genes (especially aac(6′)-Ib-cr) and ESBL genes. Conclusion The widespread detection of ESBLs-producing K. pneumoniae that co-carried PMQR determinants has become a threat to the treatment of infections in Isfahan Province of center Iran. Our findings suggest that K. pneumoniae ST11 and ST893 has a clonal distribution in our hospital. Therefore, this study highlighted the crucial need for implementing strict control measures to prevent cross transmission of these endemic clones.

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“…Interestingly, our findings revealed Klebsiella pneumonia as the indicator of CAP LRTI patients using random forest classifier, which got an AUC value of 0.804. Studies have showed that Klebsiella pneumonia are the important pathogens causing pneumonia, which are associated with high morbidity and mortality [ 50 , 51 ]. In wheezing episodes in children, Klebsiella pneumoniae are predictive markers for the prediction of wheeze [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of the lung microbiota in lower respiratory tract infections with and without history of pneumonia

Chen

2021

Bioengineered

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Lung microbiota plays an important role in many diseases including lower respiratory tract infections (LRTI) and pneumonia. This study aimed to explore the effects of community-acquired pneumonia (CAP) on microbial diversity and identify potential biomarkers of respiratory tract in CAP LRTI patients. In the current study, a comprehensive bioinformatics analysis was performed based on metagenomic next-generation sequencing technology, followed by alpha and beta diversity, LEfSe, and co-occurrence network analysis, and random forest model construction. Our results showed that CAP dramatically influenced taxon abundance, and the significant differences in microbiota including Proteobacteria, Bacteroidetes, Euryarchaeota, Firmicutes and Spirochetes were observed at the phylum level. Co-occurrence network selected out novel modules involved in microbial proliferation-associated pathways. A random forest model screened Klebsiella pneumoniae and Bacillus cereus as potential diagnostic biomarkers with high AUC values. The microbial composition was different between CAP LRTI patients and non-CAP LRTI patients. Klebsiella pneumoniae and Bacillus cereus were strongly associated with increased severity of LRTI with a pneumonia history. Our findings provided an insight for a better understanding of community and structure of lung microbiota for future diagnosis and treatment in LRTI patients with a history of pneumonia. Moreover, these microbes were considered as potential biomarkers for predicting the risks for the treatment strategies of LRTI.

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Spreading of extended-spectrum β-lactamase-producing Escherichia coli ST131 and Klebsiella pneumoniae ST11 in patients with pneumonia

Abstract: Supplemental Digital Content is available in the text

Cited by 20 publications

References 58 publications

Extended-spectrum beta-lactamases among Klebsiella pneumoniae from Iraqi patients with community-acquired pneumonia

Extended-spectrum beta-lactamases among Klebsiella pneumoniae from Iraqi patients with community-acquired pneumonia

Molecular characterization of plasmid-mediated quinolone resistance (PMQR) and ESBLs-producing Klebsiella pneumonia isolated from an Iranian teaching hospital

Characteristics of the lung microbiota in lower respiratory tract infections with and without history of pneumonia

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