Characterization of Carbapenemase-Producing <i>Klebsiella pneumoniae</i> Isolates from Two Romanian Hospitals Co-Presenting Resistance and Heteroresistance to Colistin
<i>Klebsiella pneumoniae</i> is a notorious human pathogen involved in healthcare-associated infections. The worldwide expansion of infections induced by colistin-resistant and carbapenemase-producing Enterobacterales (CPE) isolates has been increasingly reported. This study aims to anal...
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| Main Authors: | , , , , |
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| Format: | Book |
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MDPI AG,
2022-08-01T00:00:00Z.
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| Summary: | <i>Klebsiella pneumoniae</i> is a notorious human pathogen involved in healthcare-associated infections. The worldwide expansion of infections induced by colistin-resistant and carbapenemase-producing Enterobacterales (CPE) isolates has been increasingly reported. This study aims to analyze the phenotypic and molecular profiles of 10 colistin-resistant (CR) isolates and 2 pairs of colistin-heteroresistant (ChR) (parental and the corresponding resistant mutants) isolates of <i>K. pneumoniae</i> CPE sourced from two hospitals. The phenotypes of strains in the selected collection had been previously characterized. Antimicrobial susceptibility testing was performed using a Vitek 2 Compact system (BioMérieux SA, Marcy l'Etoile, France), the disc diffusion method, and broth microdilution (BMD) for colistin. Whole-genome sequencing (WGS) did not uncover evidence of any mobile colistin resistance (<i>mcr</i>) genes, although the <i>mgrB</i> gene of seven isolates appeared to be disrupted by insertion sequences (ISKpn25 or ISKpn26). Possible deleterious missense mutations were found in <i>phoP</i> (L4F), <i>phoQ</i> (Q426L, L26Q, L224Q, Q317K), <i>pmrB</i> (R256G, P95L, T157P, V352E), and <i>crrB</i> (P151S) genes. The identified isolates belonged to the following clonal lineages: ST101 (n = 6), ST147 (n = 5), ST258 (n = 2), and ST307 (n = 1). All strains harbored IncF plasmids. OXA-48 producers carried IncL and IncR plasmids, while one <i>bla</i><sub>NDM-1</sub> genome was found to harbor IncC plasmids. Ceftazidime-avibactam remains a therapeutic option for KPC-2 and OXA-48 producers. Resistance to meropenem-vaborbactam has emerged in some <i>bla</i><sub>kPC-2</sub>-carrying isolates. Our study demonstrates that the results of WGS can provide essential evidence for the surveillance of antimicrobial resistance. |
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| Item Description: | 10.3390/antibiotics11091171 2079-6382 |