Unveiling the genome of a high-risk pandrug-resistant Klebsiella pneumoniae emerging in the Brazilian Amazon Region, 2022.

IF 2.5 4区 医学 Q2 PARASITOLOGY
Memorias do Instituto Oswaldo Cruz Pub Date : 2023-10-27 eCollection Date: 2023-01-01 DOI:10.1590/0074-02760230081
Érica Lourenço Fonseca, Sérgio M Morgado, Fernanda S Freitas, Nathalia S Bighi, Rosângela Cipriano, Ana Carolina Paulo Vicente
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Abstract

Background: Pandrug-resistant (PDR) Klebsiella pneumoniae has been reported sporadically in many countries and remains rare in Brazil.

Objectives: This study unravelled the genetic determinants involved with the PDR background of a clinical ST11 K. pneumoniae recovered in the Brazilian Amazon Region, where K. pneumoniae genomic and epidemiological information is scarce.

Methods: Kp196 was submitted to the antimicrobial susceptibility test by the disk-diffusion method and minimum inhibitory concentration (MIC) determination. The whole genome sequencing was obtained and the sequence type was determined by core genome multilocus sequence typing (cgMLST). Its intrinsic and acquired resistome was assessed by Comprehensive Antibiotic Resistance Database (CARD) and comparison with wild-type genes.

Findings: The analyses revealed that Kp196 belonged to the pandemic ST11 and presented the PDR phenotype. Its acquired resistome was composed of a huge set of clinically relevant resistance determinants, including bla CTX-M-15 and bla NDM-1, all found in the vicinity of mobile platforms. Considering its intrinsic resistome, the multidrug resistance, especially to colistin, tigecycline and fluoroquinolones, was multifactorial and attributed to modifications (indels, missense mutations, and gene disruption) in several housekeeping genes (arnT/phoQ/mgrB/ramR/acrB/gyrA/parC/ompK35-36-37). The Kp196 intrinsic resistome was also observed in a ST11 environmental strain, although harbouring distinct acquired resistomes.

Conclusions: An accumulation of different resistance mechanisms regarding the intrinsic resistome accounts for a more stable resistome, strongly contributing to the Kp196 PDR phenotype.

Abstract Image

Abstract Image

2022年,公布巴西亚马逊地区出现的高风险耐泛药肺炎克雷伯菌的基因组。
背景:肺炎克雷伯菌耐药性(PDR)在许多国家零星报道,在巴西仍然很罕见。目的:本研究揭示了与在巴西亚马逊地区发现的临床ST11肺炎克雷伯菌的PDR背景有关的遗传决定因素,该地区的肺炎克雷布菌基因组和流行病学信息很少。方法:采用纸片扩散法和最小抑菌浓度(MIC)法对Kp196进行药敏试验。获得全基因组测序,并通过核心基因组多点序列分型(cgMLST)确定序列类型。通过综合抗生素耐药性数据库(CARD)评估其内在和获得性耐药性,并与野生型基因进行比较。结果:分析显示Kp196属于新冠ST11,并呈现PDR表型。其获得性耐药组由一组巨大的临床相关耐药决定因素组成,包括bla CTX-M-15和bla NDM-1,所有这些都在移动平台附近发现。考虑到其内在耐药性,多药耐药性,特别是对粘菌素、替加环素和氟喹诺酮类药物的耐药性,是多因素的,并归因于几个管家基因(arnT/phoQ/mgrB/ramR/acrB/gyrA/parC/ompK35-36-37)的修饰(indel、错义突变和基因破坏)。在ST11环境菌株中也观察到Kp196内在抗性,尽管其具有不同的获得性抗性。结论:关于内在抗性组的不同抗性机制的积累导致了更稳定的抗性组,对Kp196 PDR表型有很大贡献。
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来源期刊
CiteScore
5.00
自引率
3.60%
发文量
91
审稿时长
3-8 weeks
期刊介绍: Memórias do Instituto Oswaldo Cruz is a journal specialized in microbes & their vectors causing human infections. This means that we accept manuscripts covering multidisciplinary approaches and findings in the basic aspects of infectious diseases, e.g. basic in research in prokariotes, eukaryotes, and/or virus. Articles must clearly show what is the main question to be answered, the hypothesis raised, and the contribution given by the study. Priority is given to manuscripts reporting novel mechanisms and general findings concerning the biology of human infectious prokariotes, eukariotes or virus. Papers reporting innovative methods for diagnostics or that advance the basic research with these infectious agents are also welcome. It is important to mention what we do not publish: veterinary infectious agents research, taxonomic analysis and re-description of species, epidemiological studies or surveys or case reports and data re-analysis. Manuscripts that fall in these cases or that are considered of low priority by the journal editorial board, will be returned to the author(s) for submission to another journal.
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