Klebsiella aerogenes Dotaz Zobrazit nápovědu
Enterobacter spp. and Klebsiella aerogenes are rod-shaped Gram-negative opportunistic pathogens. This study aimed at the molecular and genomic characterization of multidrug resistant Enterobacter spp. and K. aerogenes isolates recovered from hospitalized patients in a tertiary care hospital in Lebanon. A total of 59 Enterobacter spp. clinical isolates consisting of 41 carbapenem-resistant and 18 susceptible by Etest were included in this study. Genotypic identification through whole-genome sequencing (WGS) was performed and confirmed in silico. Resistance and plasmid profiles were studied using ResFinder4.0 and Plasmid-Finder2.1. Multilocus sequence typing (MLST) was used to determine the isolates' clonality. Using the average nucleotide identity (ANI) we identified and confirmed that 47 (80%) isolates were E. hormaechei, 11 (18%) were Klebsiella aerogenes and 1 (2%) was an E. cloacae. Carbapenem-resistance was detected among 41 isolates all showing an MIC90 of ≥ 32 μg/mL for ertapenem, imipenem, and meropenem. blaNDM-1 (58.5%), blaACT-16 (54%), and blaOXA-1 (54%) were the most common detected β-lactamases, while blaCTX-M-15 (68%) was the main detected extended-spectrum β-lactamase (ESBL) encoding gene. Chromosomal ampC, carbapenemase encoding genes, and porin modifications were among the detected carbapenem resistance determinants. The carbapenemase encoding genes were linked to three well-defined plasmid Inc groups, IncFII/IncFIB, IncX3, and IncL. MLST typing revealed the diversity within the studied isolates, with ST114 being the most common among the studied E. hormaechei.: The spread of carbapenem-resistant isolates in clinical settings in Lebanon is a serious challenge. Screening and continuous monitoring through WGS analysis could effectively limit the dissemination of drug-resistant isolates in hospitalized patients. IMPORTANCE Drug resistance is an increasing global public health threat that involves most disease-causing organisms and antimicrobial drugs. Drug-resistant organisms spread in health care settings, and resistance to multiple drugs is common. Our study demonstrated the mechanisms leading to resistance against the last resort antimicrobial agents among members of the Enterobacteriaceae family. The spread of carbapenem-resistant bacteria in clinical settings is a serious challenge. Screening and continuous monitoring could effectively limit the dissemination of drug-resistant isolates in hospitalized patients.
- MeSH
- antibakteriální látky farmakologie terapeutické užití MeSH
- bakteriální proteiny genetika MeSH
- beta-laktamasy genetika MeSH
- Enterobacter aerogenes * genetika MeSH
- Enterobacter genetika MeSH
- karbapenemy farmakologie MeSH
- Klebsiella pneumoniae genetika MeSH
- lidé MeSH
- mikrobiální testy citlivosti MeSH
- multilokusová sekvenční typizace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Libanon MeSH
Národní referenční laboratoř pro antibiotika, Státní zdravotní ústav, Praha, zaznamenala výskyt nově popsaného druhu Klebsiella variicola v rámci surveillance antibiotické rezistence invazivních kmenů Klebsiella pneumoniae. Blízká příbuznost a případná záměna s K. pneumoniae může být příčinou podcenění významu tohoto druhu u humánních klinických onemocnění.
The National Reference Laboratory for Antibiotics, National Institute of Public Health, Prague, has reported the occurrence of the newly described species, Klebsiella variicola, in the context of surveillance of antimicrobial resistance of invasive strains of Klebsiella pneumoniae. The close relationship to and possible misidentification with K. pneumoniae may cause an underestimation of the importance of this species in human clinical disease.
Študovali sme ovplyvnenie povrchovej hydrofobicity kmeňa Klebsiella pneumoniae po účinkuofloxacínu, pefloxacínu a tobramycínu v subinhibičných koncentráciách (1/4, 1/8 a 1/16 MIC). Tes-tované antibiotiká v koncentračnej závislosti znížili bunkovú povrchovú hydrofobicitu. Najúčinnej-šia redukcia bola zistená po pôsobení 1/4 MIC testovaných antibiotík. Bunková hydrofobicitaúčinkom týchto koncentrácií bola znížená na 44 % (ofloxacín), 50,7 % (pefloxacín) a 56,1 % (tobramy-cín) kontrolných hodnôt.
The effect of ofloxacin, pefloxacin and tobramycin at subinhibitory concentrations (1/4, 1/8 and 1/16of the MICs) on surface hydrophobicity of the Klebsiella pneumoniae strain was studied. Theantibiotics tested decreased cell surface hydrophobicity in a dose-dependent manner. The mostsignificant reduction of surface hydrophobicity was found after treatment with antibiotics at 1/4 oftheir MICs. Surface hydrophobicity of K. pneumoniae after exposure to these concentrations wasdecreased to 44% (ofloxacin), 50.7% (pefloxacin) and 56.1% (tobramycin) compared with controls.
Cieľ práce: Cieľom štúdie bolo stanovenie prevalencie ESBL-pozitívnych izolátov Klebsielh pneumoniae u pacientov v intenzívnej starostlivosti a ich molekulárno-biologická analýza. Materiál a metódy: V období 5 mesiacov boli od pacientov hospitalizovaných na Klinike anestéziológie a resuscitácie Fakultnej nemocnice Olomouc izolované kmene Klehsiella pneumoniae. U každého izolátu bol určený antibiogram štandardnou dilučnou mikrometódou a produkcia ESBL bola stanovená modifikovaným double disk synergy testom. Na dôkaz prítomnosti génu blaTEM a blaSHV bola použitá PCR. Izoláty produkujúce SHV a TEM typy β-laktamáz boh ďalej typizované použitím metódy polymorfizmu dĺžky restrikčných fragmentov (RFLP) na identifikáciu najbežnejšie sa vyskytujúcich mutácií zodpovedných za vznik ESBL fenotypu. Posúdenie podobnosti, resp. identity izolátov, bolo uskutočnené pulznou gelovou elektroforézou (PFGE) fragmentov DNA, naštiepených pomocou reštrikčnej endonukleázy Xbal. Výsledky: Celkovo bolo získaných 67 izolátov Klebsiella pneumoniae. U 13 z nich bola stanovená produkcia ESBL a pomocou PCR dokázaná pritomnost WasHv génu. Reštrikčné štiepenie pomocou Nhel odhalilo výskyt mutácie v pozícii 238 u všetkých SHV-pozitívnych PCR produktov. Prítomnosť génu kódujúceho širokospektrú β-laktamázu TEM typu však nebola potvrdená. Molekulárno-biologická typizácia pomocou PFGE zistila prítomnosť 11 rôznych kmeňov. Záver. Prevalencia ESBL-pozitívnych kmeňov KlebsieJJa pneumoniae dosiahla u sledovanej skupiny pacientov v intenzívnej starostlivosti hodnoty 19,4 %. Analýza SHV a TEM produktov PCR metódou RFLP preukázala výskyt ESBL typu SHV. Celkovo 84,6 % kmenov malo jedinečný reštrikčný profil. Výsledky dokladujú nielen dobrú úroveň hygienicko-epidemiologických režimov na sledovanej klinike, ale aj racionálnu antibiotickú politiku.
Objectives: The study aimed at the assessment of the prevalence of ESBL-positive isolates of Klebsiella pneumoniae in intensive care patients and their molecular biology analysis. Material and methods: Over a 5-month period, Klebsiella pneumoniae strains were isolated from patients hospitalized at the Department of Anaesthesiology and Resuscitation of the University Hospital in Olomouc. For each isolate, an antibiogram was performed by the standard microdilution method and the production of ESBL was determined by the modified double-disk synergy test. PCR was used to demonstrate the presence of the blaTEM and blaSHV genes. The isolates producing SHV- and TEM-types of β-lactamases were typed using the restriction fragment length polymorphism (RFLP) method to identify the most common mutations responsible for the development of an ESBL phenotype. Similar or identical isolates were determined by pulsed-field gel electrophoresis (PFGE) of DNA fragments cleaved by the XbaI restriction endonuclease. Results: A total of 67 isolates of KJebsieJJa pneumoniae were obtained. In 13 of them, the production of ESBL was detected and the presence of the blaSHV gene was confirmed by PCR. Restriction cleavage by Nhei revealed mutations at position 238 in all SHV-positive PCR products. The restriction analysis did not confirm the presence of the gene encoding TEM-type extended-spectrum β-lactamase. Molecular biology typing by PFGE detected the presence of 11 different strains. Conclusions: In the observed group of intensive care patients, the prevalence of ESBL-positive strains of Klebsiella pneumoniae reached 19.4 %. The analysis of SHV and TEM products of PCR by the RFLPP method showed the prevalence of SHV-type ESBL. Overail, 84.6 % of the strains had unique restriction profiles. The results suggest both high levels of hygienic and epidemiological measures at the monitored department and rational antibiotic policy.
Hypervirulentní kmeny Klebsiella pneumoniae (hvKP) mohou způsobovat atypické multilokulární infekce u jinak zdravých pacientů. Diagnostika infekce vyvolané hvKP je založena především na klinickém nálezu a laboratorních výsledcích včetně detekce genů virulence. Typicky se projevuje jako jaterní absces s metastatickým šířením. Léčba je založena na chirurgickém řešení v kombinaci s cílenou antimikrobiální terapií. Výskyt infekce hvKP je relativně častý v Asii. V Evropě je sice stále vzácný, ale incidence onemocnění se zvyšuje. Cílem článku je poskytnout stručný přehled problematiky a upozornit na možný výskyt infekcí hvKP.
Hypervirulent strains of Klebsiella pneumoniae (hvKP) can cause atypical multilocular infections in otherwise healthy patients. Diagnosis of infection caused by hvKP is based mainly on clinical findings and laboratory results, including detection of virulence genes. It typically manifests as hepatic abscess with metastatic spread. Treatment is based on surgical intervention in combination with targeted antimicrobial therapy. The occurrence of hvKP infection is relatively common in Asia, and while still rare in Europe, incidence is increasing. The article aims to provide a short overview of the issue and increase awareness of the possible occurrence of hvKP infections.
- MeSH
- amputace MeSH
- antibakteriální látky terapeutické užití MeSH
- dospělí MeSH
- faktory virulence MeSH
- infekce bakteriemi rodu Klebsiella * diagnóza epidemiologie terapie MeSH
- infekce měkkých tkání chirurgie diagnóza etiologie farmakoterapie MeSH
- Klebsiella pneumoniae MeSH
- lidé MeSH
- sepse MeSH
- virulence MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
