Whole-Genome Sequences of Two Carbapenem-Resistant Klebsiella quasipneumoniae Strains Isolated from a Tertiary Hospital in Johor, Malaysia

Gan, Han Ming; Rajasekaram, Ganeswrie; Eng, Wilhelm Wei Han; Kaniappan, Priyatharisni; Dhanoa, Amreeta

doi:10.1128/genomea.00768-17

Cited by 14 publications

(5 citation statements)

References 10 publications

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“…These studies tackled hypervirulence in community-acquired K. quasipneumoniae isolates 44–46 . Even fewer studies have described MDR K. quasipneumoniae 47,48 . We were the first to identify and report the presence of carbapenem resistant K. quasipneumoniae in the Middle East.…”

Section: Discussionmentioning

confidence: 99%

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

Arabaghian

Salloum

Alousi

et al. 2019

Sci Rep

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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.

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Section: Discussionmentioning

confidence: 99%

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

Arabaghian

Salloum

Alousi

et al. 2019

Sci Rep

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“…Although there have only been a few reports of K. quasipneumoniae since its definition as a species in 2014, it appears that this organism is widespread (2, 5, 24, 25). As seen here, it is not readily distinguished from K.…”

Section: Discussionmentioning

confidence: 99%

Klebsiella quasipneumoniae Provides a Window into Carbapenemase Gene Transfer, Plasmid Rearrangements, and Patient Interactions with the Hospital Environment

Mathers

Crook

Vaughan

et al. 2019

Antimicrob Agents Chemother

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Several emerging pathogens have arisen as a result of selection pressures exerted by modern health care. Klebsiella quasipneumoniae was recently defined as a new species, yet its prevalence, niche, and propensity to acquire antimicrobial resistance genes are not fully described. We have been tracking inter- and intraspecies transmission of the Klebsiella pneumoniae carbapenemase (KPC) gene, blaKPC, between bacteria isolated from a single institution. We applied a combination of Illumina and PacBio whole-genome sequencing to identify and compare K. quasipneumoniae from patients and the hospital environment over 10- and 5-year periods, respectively. There were 32 blaKPC-positive K. quasipneumoniae isolates, all of which were identified as K. pneumoniae in the clinical microbiology laboratory, from 8 patients and 11 sink drains, with evidence for seven separate blaKPC plasmid acquisitions. Analysis of a single subclade of K. quasipneumoniae subsp. quasipneumoniae (n = 23 isolates) from three patients and six rooms demonstrated seeding of a sink by a patient, subsequent persistence of the strain in the hospital environment, and then possible transmission to another patient. Longitudinal analysis of this strain demonstrated the acquisition of two unique blaKPC plasmids and then subsequent within-strain genetic rearrangement through transposition and homologous recombination. Our analysis highlights the apparent molecular propensity of K. quasipneumoniae to persist in the environment as well as acquire carbapenemase plasmids from other species and enabled an assessment of the genetic rearrangements which may facilitate horizontal transmission of carbapenemases.

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“…Although there have only been a handful of reports of K. quasipneumoniae since its definition as a species in 2014, it does appear that this organism is widespread(2, 5, 20, 21). As seen here, it is not readily distinguished from K. pneumoniae with current clinical microbiology techniques and thus the true prevalence is unknown(2, 22).…”

Section: Discussionmentioning

confidence: 99%

Klebsiella quasipneumonaiae provides a window into carbapenemase gene transfer, plasmid rearrangements and nosocomial acquisition from the hospital environment

Mathers

Crook

Vaughan

et al. 2018

Preprint

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22Several emerging pathogens have arisen as a result of selection pressures exerted by modern healthcare. 23Klebsiella quasipneumoniae was recently defined as a new species, yet its prevalence, niche, and propensity to 24 acquire antimicrobial resistance genes are not fully described. We have been tracking inter-and intra-species 25 transmission of the Klebsiella pneumoniae carbapenemase (KPC) gene, bla KPC , between bacteria isolated from a 26 single institution. We applied a combination of Illumina and PacBio whole-genome sequencing to identify and 27 compare K. quasipneumoniae from patients and the hospital environment over 10 and five-year periods 28respectively. There were 32 bla KPC -positive K. quasipneumoniae isolates, all of which were identified as K. 29 pneumoniae in the clinical microbiology laboratory, from eight patients and 11 sink drains, with evidence for 30 seven separate bla KPC plasmid acquisitions. Analysis of a single subclade of K. quasipneumoniae subspecies 31 quasipneumoniae (n=23 isolates) from three patients and six rooms demonstrated seeding of a sink by a patient, 32 subsequent persistence of the strain in the hospital environment, and then probable transmission to another 33 patient. Longitudinal analysis of this strain demonstrated the acquisition of two unique bla KPC plasmids and then 34 subsequent within-strain genetic rearrangement through transposition and homologous recombination. Our 35 analysis highlights the apparent molecular propensity of K. quasipneumoniae to persist in the environment as well 36as acquire carbapenemase plasmids from other species and enabled an assessment of the genetic rearrangements 37

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Whole-Genome Sequences of Two Carbapenem-Resistant Klebsiella quasipneumoniae Strains Isolated from a Tertiary Hospital in Johor, Malaysia

Cited by 14 publications

References 10 publications

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

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

Klebsiella quasipneumoniae Provides a Window into Carbapenemase Gene Transfer, Plasmid Rearrangements, and Patient Interactions with the Hospital Environment

Klebsiella quasipneumonaiae provides a window into carbapenemase gene transfer, plasmid rearrangements and nosocomial acquisition from the hospital environment

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