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Extensively drug-resistant Klebsiella pneumoniae associated with complicated urinary tract infection in Northern India

Abstract:
Klebsiella pneumoniae (Kp), which is associated with hospital-acquired infections, is extensively drug-resistant (XDR), making treatment difficult. Understanding the genetic epidemiology of XDR-Kp can help determine its potential to be hypervirulent (hv) through the presence of siderophores. We characterized the genomes of 18 colistin-resistant XDR-Kp isolated from 14 patients with complicated tract infection at an Indian healthcare facility. The 18 organisms comprised the following sequence types (STs): ST14 (n = 9), ST147 (n = 5), ST231 (n = 2), ST2096 (n = 1), and ST25 (n = 1). Many patients in each ward were infected with the same ST, suggesting a common source of infection. Some patients had recurrent infections with multiple STs circulating in the ward, providing evidence of hospital transmission. β-lactamase genes (blaCTX-M-1, blaSHV, and blaampH) were present in all isolates. blaNDM-1 was present in 15 isolates, blaOXA-1 in 16 isolates, blaTEM-1D in 13 isolates, and blaOXA-48 in 3 isolates. Disruption of mgrB by various insertion sequences was responsible for colistin resistance in 6 isolates. The most common K-type among isolates was K2 (n = 10). One XDR convergent hvKp ST2096 mutation (iuc+ybt+blaOXA-1+blaOXA-48) was associated with prolonged hospitalization. Convergent XDR-hvKp has outbreak potential, warranting effective antimicrobial stewardship and infection control.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.7883/yoken.jjid.2023.009

Authors


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Role:
Author
ORCID:
0000-0001-8456-5874
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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0003-1308-5755


Publisher:
National Institute of Infectious Diseases
Journal:
Japanese Journal of Infectious Diseases More from this journal
Volume:
77
Issue:
1
Pages:
7-15
Place of publication:
Japan
Publication date:
2023-08-31
Acceptance date:
2023-08-08
DOI:
EISSN:
1884-2836
ISSN:
1344-6304
Pmid:
37648492


Language:
English
Keywords:
Pubs id:
1518451
Local pid:
pubs:1518451
Deposit date:
2025-01-14

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