Frontiers whole genome sequencing of extendedspectrum. Klebsiella pneumoniae is an encapsulated gramnegative bacterium that is frequently found in the flora of the mouth, skin and intestines as well as in natural environments 1. We carried out a wgs study to understand the genetic background of esblproducing kpn in malawi and place them in the context of other global isolates. Most bla ndm1carrying isolates contained bla ctxm15, bla oxa1, bla oxa2 and bla tem1 genes. The antimicrobial susceptibility of klebsiella pneumoniae. Esbl production was detected in 8 strains of klebsiella pneumoniae. We report mcr1 colistin resistance in esblproducing k. High prevalence of esblproducing klebsiella pneumoniae in. Extendedspectrum beta lactamase genes of klebsiella pneumoniae strains in taiwan. In the collection of clinical hospital samples, we found eight of 15 e. Klebsiella pneumoniae identification of producing extended spectrum beta lactamase esbl and resistance. This study was done to determine the susceptibility of different antimicrobials to esbl producing escherichia coli and klebsiella pneumoniae isolated from wound. Vim, imp and ndm enzymes and class d carbapenemases e.
Klebsiella associated infection is the emergence of multidrug resistant strains particularly those involved in nosocomial diseases. Bloodstream infections by extendedspectrum beta lactamase producing escherichia coli and klebsiella pneumoniae in children. We carried out a wgs study to understand the genetic background of esbl producing kpn in malawi and place them in the context of other global isolates. Cultures of the gastrointestinal tracts of patients, the hands of healthcare workers hcws, and the environment were performed to detect potential reservoirs for esblproducing k. This study aimed to detect the presence of qnr genes in esblproducing e. Carbapenemresistant enterobacteriaceae cre pdf icon pdf 24 pages general information klebsiella kleb. Klebsiella pneumoniae an overview sciencedirect topics. Klebsiella pneumoniae klebpnoverview eppo global database. Esblproducing strain of hypervirulent klebsiella pneumoniae k2, france. From april to june 2001, an outbreak of extendedspectrum beta lactamase esblproducing klebsiella pneumoniae infections was investigated in our neonatal intensive care unit. Cultures of the gastrointestinal tracts of patients, the hands of healthcare workers hcws, and the environment were performed to detect potential reservoirs. A total of two hundred and fifteen 215 clinical isolates were examined, of which 60% were e. Lactamaseproducing klebsiella pneumoniae esblkp in an acute care hospital.
Klebsiella is a bacteria that can cause different types of infections such as a urinary tract infection or pneumonia, and is considered a not very common pathogen among patients in the community meaning outside the hospital. Klebsiella pneumoniae antimicrobial drug resistance. The incidence of healthcareassociated esblkpn bacteremia was evaluated before and after initiating. These isolates were screened for esbl production by the inhibitor based test recommended by the national committee for clinical laboratory standards nccls using.
The incidence of healthcareassociated esblkpn bacteremia was evaluated before and after. Other tests showed that there was persontoperson spread of these antibioticresistant bacteria. Klebsiella pneumoniae is a gramnegative, nonmotile, lactose fermenting, rodshape organism. To survive the effects of antibiotics, germs are constantly finding new. Results the investigation comprises 37 cases and the 10 cases with esbl extendedspectrum beta lactamase producing k. Klebsiella pneumoniae in healthcare settings hai cdc. Descriptive epidemiology indicated that a continuous transmission from person to person was most likely. This organism is also surrounded by a capsule, which increases its virulence by acting as a physical barrier to evade the hosts immune response.
Qnr genes are known to confer a lowlevel resistance to fluoroquinolone in enterobacteriaceae. Neutrophilic and necrotizing with an exudate and fibrin filling the airspaces. High prevalence of esblproducing klebsiella pneumoniae in clinical samples from. Distribution of quinolone resistance gene qnr in esbl. Jun 18, 2019 qnr genes are known to confer a lowlevel resistance to fluoroquinolone in enterobacteriaceae. Klebsiella pneumoniae has been a leading health careacquired infection hai agent for decades 1, 2. Bloodstream infections by extendedspectrum beta lactamase producing escherichia coli and. Extended spectrum cephalosporins, such as the third generation cephalosporins, were originally thought to be resistant to hydrolysis by betalactamases. A 7year surveillance of the drug resistance in klebsiella. Klebsiella pneumoniae is a ubiquitous gramnegative encapsulated bacterium that resides in the mucosal surfaces of mammals and the environment soil, water, etc. Klebsiella pneumoniae solates from the hospital environment had antibiogram similar to the patient samples.
Antibiotic therapy for klebsiella pneumoniae bacteremia. Klebsiella pneumoniae strains producing extended spectrum. Increasing antimicrobial drug resistance, including carbapenemresistant k. The genus klebsiella was named after the german microbiologist edwin klebs 183419. Investigation and control of vancomycinresistant staphylococcus aureus vrsa pdf icon pdf 300 kb cdc. Attributable costs and length of stay of an extendedspectrum beta lactamase producing klebsiella pneumoniae outbreak in a neonatal intensive care unit. In this study, we evaluated the genetic relatedness of extendedspectrum beta lactamase producing klebsiella pneumoniae esblkpn isolates from an outbreak in a neonatal intensive care unit nicu in august 2017, we implemented an active countermeasure to control this outbreak successfully. Evaluation of hardychrom esbl as a detection method of esblproducing escherichia coli, klebsiella pneumoniae, and klebsiella oxytoca. Outbreak of extendedspectrum betalactamaseproducing.
Escherichia coli and klebsiella pneumoniae are common esbl producing enterobacteriaceae found worldwide, 5 and cause various infectious diseases in both hospital and community settings. Genetic evolution and clinical impact in extendedspectrum beta lactamase producing escherichia coli and klebsiella pneumoniae. The esbl activity could be experimentally transferred to recipient li k12 j622. Adequate empirical therapy was administered in 74% of infections caused by non esbl nonkpc strains, versus 33%. Klebsiella pneumoniae is an important cause of neonatal sepsis and cross transmission can occur from the hospital environment. Pdf distribution of nosocomial infections caused by.
It appears as a mucoid lactose fermenter on macconkey agar although found in the normal flora of the mouth, skin, and intestines, it can cause destructive changes to human and animal lungs if aspirated, specifically to the alveoli resulting in bloody, brownish. A substantially increasing trend of ndm1producing k. In healthcare settings, klebsiella bacteria can be spread through persontoperson contact for example, from patient to patient via the contaminated hands of healthcare personnel, or other persons or, less. In this study, the prevalence of extended spectrum beta lactamase esbl producing klebsiella pneumoniae and escherichia coli isolates from the university of abuja teaching hospital and the national hospital was determined. Tem and shv type esbl producing were klebsiella pneumoniae. Pfge analysis clustered ndm1 producers into five distinct clonal. Research article prevalence of esblproducing klebsiella. It is known as a pathogen that attacks hospitalized patients at a higher frequency and needds good antibiotic treatment. Thirty percent of such infections acquired during hospitalization and 43% of infections acquired in the intensive care unit were esblproducing.
The disease is usually seen only in patients with underlying medical. We summarize the wide resistome of this pathogen, which encompasses plentiful chromosomal and plasmidencoded antibiotic resistance genes args. Continuing to use this website means you agree to our use of cookies. Resistance that is produced through the actions of betalactamases. Klebsiella pneumoniae presents antimicrobial drug resistance for.
We identified 217 unique patient bsis, including 92 42% kpcpositive, 49 23% esblpositive, and 1 0. Adequate empirical therapy was administered in 74% of infections caused by nonesbl nonkpc strains, versus 33%. Klebsiella pneumoniae is mainly responsible for hospitalacquired urinary tract infections, bacteremia, pneumonia and intraabdominal infections. Esblproducing klebsiella pneumoniae kpn pose a major threat to human health globally. Molecular analysis confirmed the presence of the bla ndm1 gene in 341 71% k. Escherichia coli and klebsiella pneumoniae are common esblproducing enterobacteriaceae found worldwide, 5 and cause various infectious diseases in both hospital and community settings. Drugresistant klebsiella pneumoniae, especially extendedspectrum. They are often found on the same resistance plasmids as extended spectrum. In enterobacteriaceae and particularly in klebsiella pneumoniae, acquired ambler class a e.
Klebsiella pneumoniae causes a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses. Comparisons of microbiological characteristics and. The communityassociated klebsiella pneumoniae has gradually increased 1 and caused liver abscesses in diabetic patients 2. A gramnegative pneumonia that can cause both nosocomial and communityacquired pneumonia.
In this study we report on the molecular characterization through whole genome sequencing of an esbl. Carbapenems, such as imipenem and meropenem, are often used to treat infections caused by extendedspectrum beta lactamase esblproducing. Detection, surveillance, prevention and control biomerieux. Pdf klebsiella pneumoniae identification of producing. For example, klebsiella must enter the respiratory breathing tract to cause pneumoniae, or the blood to cause a bloodstream infection. The esblproducing klebsiella pneumoniae constitutes one of the most common multidrugresistant mdr groups of gramnegative bacteria involved in nosocomial infections worldwide. Worldwide prevalence of antibiotic resistance in the. Extended spectrum beta lactamase esbl mediated resistance to. A comparison of extendedspectrum betalactamase esbl. However, some epidemiological changes have been observed since the emergence of ctxm enzymes in k. Klebseq, a diagnostic tool for surveillance, detection.
In healthcare settings, klebsiella bacteria can be spread through persontoperson contact for example, from patient to patient via the contaminated. Bacteremic pneumonia caused by extendedspectrum beta. Pdf infections caused by extendedspectrum betalactamase esblproducing pathogens, particularly klebsiella pneumoniae, are increasing. Klebsiella pneumoniae is an important multidrugresistant mdr pathogen affecting humans and a major source for hospital infections associated with high morbidity and mortality due to limited treatment options. Klebsiella pneumoniae, carbapenem, esbl, ampc, outermembrane protein, insertion sequences. Risk factors for infection by extendedspectrum betalactamase. Risk of infection and carriage rates of klebsiella spp. Esblproducing strain of hypervirulent klebsiella pneumoniae. Previous studies describing the isolation of lytic.
Antibiogram of extended spectrum betalactamase esbl. Pdf on jan 1, 2012, sadeta had and others published distribution of nosocomial infections caused by klebsiella pneumoniae esbl strain find, read and cite all the research you need on researchgate. Among 39 resistant isolates of klebsiella pneumoniae, 17 were esbl producers detected by ddst. We identified 217 unique patient bsis, including 92 42% kpcpositive, 49 23% esbl positive, and 1 0. Genomic analysis of klebsiella pneumoniae isolates from. Gramnegative bacilli gnb are common agents of nosocomial infections. Klebseq, a diagnostic tool for surveillance, detection, and. We sequenced the available isolates to determine the phylogenetic relatedness of klebsiella pneumoniae isolates on the basis of their genome sequences. Comparisons of microbiological characteristics and antibiotic. Pdf extended spectrum lactamaseproducing klebsiella.
To get a klebsiella infection, a person must be exposed to the bacteria. Introduction to klebsiella pneumoniae carbapenemases. Pdf esblproduction in escherichia coli and klebsiella. Seroepidemiology of klebsiella pneumoniae colonizing the intestinal tract of healthy chinese and overseas chinese adults in asian countries. Colocalization of carbapenemases or extendedspectrum. Furthermore, almost 30% of escherichia coli in the study were found to be resistant to. What caused the outbreak of esblproducing klebsiella. To analyse the transmission dynamics of extended spectrum. A comparison of extendedspectrum beta lactamase esblproducing escherichia coli and klebsiella pneumoniae bloodstream infections in alberta using a provincial surveillance system kathryn r.
Tigecycline or colistin must be used for infection by mbl producing k. Emergence of ndm1producing klebsiella pneumoniae in greece. Klebsiella species is a topic covered in the johns hopkins abx guide to view the entire topic, please sign in or purchase a subscription official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine. General information about klebsiella pneumoniae klebpn this website uses cookies our website uses cookies to ensure that we give you the best possible online experience. Klebsiella pneumoniae, also called friedlanders bacillus, was first described in 1882 by german microbiologist and pathologist carl friedlander. Multiplex realtime pcr detection of klebsiella pneumoniae carbapenemase kpc and new delhi metallo. The alarming rise in resistance to shv and esbl producing groups of antibiotics result in high morbidity and mortality. Insertion sequencedependent ompk36 mutation associated.
Examples of germs in the enterobacteriaceae family include escherichia coli e. Pyogenic liver abscess caused by klebsiella pneumoniae. All the isolates from the environmental samples were found to be multidrug resistant and amp c positive. We report intestinal carriage of an extendedspectrum. Klebsiella pneumoniae has been responsible for a large number of clonal hospital outbreaks. Nicu in august 2017, we implemented an active countermeasure to control this outbreak successfully. The increased prevalence of klebsiella pneumoniae infections and resistance rates are a current cause for concern. It is important to note that the nccls confirmatory tests are only intended for the detection of esbls found ine.
Nosocomial infections, esbl, klebsiella pneumoniae, bacterial resistance. Klebsiella pneumoniae definition of klebsiella pneumoniae. Successful control of an extendedspectrum betalactamase. Implications of production of extendedspectrum blactamases david l. Esbl producing klebsiella pneumoniae kpn pose a major threat to human health globally. Other articles where klebsiella pneumoniae is discussed. Enterobacteriaceae are a large family of different types of bacteria germs that commonly cause infections both in healthcare settings and in communities.
Klebsiella pneumoniae is a gramnegative, nonmotile, encapsulated, lactosefermenting, facultative anaerobic, rodshaped bacterium. Results from the cohort study showed that frequent manipulation a proxy for increased exposure to medical procedures was. The prevalence and molecular profile of the esblproducing escherichia coli is. We do not use these to store personal information about you. These isolates were screened for esbl production by the inhibitor based test recommended by the national committee for clinical laboratory standards nccls using klebsiella pneumoniae atcc 700603. Emergence of ndm1producing klebsiella pneumoniae in. Esbls are most commonly detected in klebsiella pneumoniae, which is an opportunistic pathogen associated with severe infections in hospitalized patients, including. The strain had the mcr1 plasmid gene and an inactivated mgrb gene, which are associated with colistin resistance.
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