Issa Ndiaye , Laurent Debarbieux , Ousmane Sow , Bissoume Sambe Ba , Moussa Moise Diagne , Abdoulaye Cissé , Cheikh Fall , Yakhya Dieye , Ndongo Dia , Guillaume Constantin de Magny , Abdoulaye Seck
{"title":"Isolation and characterization of Acinetobacter phage vAbaIN10 active against carbapenem-resistant Acinetobacter baumannii (CRAB) isolates from healthcare-associated infections in Dakar, Senegal","authors":"Issa Ndiaye , Laurent Debarbieux , Ousmane Sow , Bissoume Sambe Ba , Moussa Moise Diagne , Abdoulaye Cissé , Cheikh Fall , Yakhya Dieye , Ndongo Dia , Guillaume Constantin de Magny , Abdoulaye Seck","doi":"10.1016/j.jgar.2024.12.024","DOIUrl":"10.1016/j.jgar.2024.12.024","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB) is a critical antimicrobial resistance threat and a WHO-prioritized pathogen. With intrinsic resistance to multiple antibiotics and the emergence of pan-resistant isolates, CRAB infections are challenging to treat, often relying on polymyxins, tigecycline, aminoglycosides, or combinations, though co-resistance is rising globally. Phage therapy is considered as a potential treatment for multidrug-resistant <em>A. baumannii</em>. This study focused on isolating and characterizing phages active against CRAB strains from healthcare-associated infections in Dakar, Senegal.</div></div><div><h3>Methods</h3><div>A lytic phage, <em>Acinetobacter</em> vAbaIN10, was isolated from wastewater collected at the Aristide Le Dantec Hospital in Dakar, Senegal. Isolation, host range, efficiency of plating, temperature and pH stability, lysis kinetics, one-step growth test, sequencing, and genomic analysis were performed.</div></div><div><h3>Results</h3><div>Phage vAbaIN10 belongs to the class <em>Caudoviricetes</em> and the genus <em>Friunavirus</em>. Its genome is 40,279 bp in size. Phage vAbaIN10 is stable across a wide pH range (3–9) and temperature range (25°C–60°C). The phage's lytic activity was evaluated at different multiplicities of infection (MOI): MOI 10, 1, and 10⁻¹. All MOIs significantly reduced the growth of host bacteria. The one-step growth curve showed that vAbaIN10 had a latency period of 25 min and a burst size of approximately 4.78 × 10³ phages per infected bacterial cell. No tRNA, mtRNA, clustered regularly interspaced short palindromic repeat, virulence factors, or antibiotic resistance genes were found in the genome.</div></div><div><h3>Conclusions</h3><div>The biological and genomic characteristics of vAbaIN10 meet the requirements for its potential use in phage therapy.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 151-158"},"PeriodicalIF":3.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jorge Rodríguez-Gómez , Irene Gracia-Ahufinger I , Rosario Carmona-Flores , Julia Guzmán-Puche , Rafael León , Elena Pérez-Nadales , Monserrat Muñoz de la Rosa , Alejandra Mendez Natera , Juan José Castón , Ángela Cano , Juan Jesús Pineda-Capitán , Cristina López , Carmen De la Fuente-Martos , Julián Torre-Cisneros , Luis Martínez-Martínez
{"title":"Efficacy of high doses of intravenous fosfomycin for treatment of urinary tract infection caused by KPC carbapenemase-producing Klebsiella pneumoniae: An observational study","authors":"Jorge Rodríguez-Gómez , Irene Gracia-Ahufinger I , Rosario Carmona-Flores , Julia Guzmán-Puche , Rafael León , Elena Pérez-Nadales , Monserrat Muñoz de la Rosa , Alejandra Mendez Natera , Juan José Castón , Ángela Cano , Juan Jesús Pineda-Capitán , Cristina López , Carmen De la Fuente-Martos , Julián Torre-Cisneros , Luis Martínez-Martínez","doi":"10.1016/j.jgar.2024.12.013","DOIUrl":"10.1016/j.jgar.2024.12.013","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of high-dose intravenous fosfomycin for the treatment of urinary tract infections (UTI) caused by KPC carbapenemase-producing <em>Klebsiella pneumoniae</em> (KPC-Kp). A secondary objective was to evaluate the impact of the results of fosfomycin susceptibility testing on prognosis.</div></div><div><h3>Methods</h3><div>This is an observational and retrospective study. Patients hospitalized with UTI caused by KPC-Kp receiving treatment with high-dose intravenous fosfomycin were evaluated from December 2012 to June 2018. The primary outcome variable was clinical cure at d 21.</div></div><div><h3>Results</h3><div>Forty-seven patients were included. The results of commercial microdilution panels showed that KPC-Kp isolates from 14 (29.8%) and 33 (70.2%) patients were non-susceptible and susceptible to fosfomycin, respectively. In 28 available isolates, susceptibility was also determined by the reference agar dilution method. In the global cohort, clinical cure was achieved at d 21 for 33 (70.2%) out of the 47 patients, with no statistical differences found between fosfomycin non-susceptible isolates and fosfomycin susceptible isolates as determined by commercial microdilution (78.6 vs. 66.7%; <em>P</em> = 0.50) or by the reference agar dilution (83.3 vs. 72.7%; <em>P</em> = 1). In the logistic regression analysis, the Pitt index was the only variable related to clinical cure at 21 d. No statistically significant differences were found for the variables associated with fosfomycin susceptibility testing or fosfomycin minimum inhibitory concentration.</div></div><div><h3>Conclusions</h3><div>High-dose intravenous fosfomycin can be considered for treatment of hospitalized patients with KPC-Kp UTI in some scenarios. in vitro fosfomycin susceptibility testing for multiresistant KPC-Kp may be of limited clinical value.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 138-143"},"PeriodicalIF":3.7,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Potential drug interaction after withdrawal of nirmatrelvir-ritonavir in hospitalized patients with COVID-19 infection.","authors":"Yun Han, Yonglan Gou, Jieqiong Liu, Lingyan Yu, Yuhua Zhao, Zhenwei Yu","doi":"10.1016/j.jgar.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.jgar.2024.12.014","url":null,"abstract":"<p><strong>Background: </strong>Nirmatrelvir-ritonavir is effective in the treatment of SARS-CoV-2 infection. It can cause drug‒drug interactions (DDIs), even several days after withdrawal, due to irreversible inhibition of the cytochrome enzyme.</p><p><strong>Methods: </strong>Hospitalized patients diagnosed with COVID-19 infection and treated with nirmatrelvir-ritonavir were retrospectively included according to preset criteria. Personal information, as well as drug use, were obtained from the hospital information system. Potential DDIs were screened and classified according to three databases (FDA fact sheet, University of Liverpool Drug Interactions resources and Lexicomp).</p><p><strong>Results: </strong>A total of 332 hospitalized patients with COVID-19 infection who received nirmatrelvir-ritonavir treatment were included in this study. The prevalence of potential DDI risk after withdrawal of nirmatrelvir-ritonavir in hospitalized patients was 57.2%. Most patients resumed potentially interacting medications on the first day of nirmatrelvir-ritonavir withdrawal, and those drugs with DDI risk at the avoidance level mainly included dexamethasone and rivaroxaban, whereas drugs at the caution level mainly included lidocaine.</p><p><strong>Conclusion: </strong>The prevalence of potential DDI risk after withdrawal of nirmatlevir-ritonavir was high and should be given more attention.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luca Pipitò , Marcello Trizzino , Chiara Mascarella , Sara Cannella , Roberta Gaudiano , Irene Ganci , Gaetano D'Alessandro , Benedetta Romanin , Maria Mercedes Santoro , Giovanni M. Giammanco , Antonio Cascio , Celestino Bonura
{"title":"Next-generation sequencing and drug resistance mutations of HIV-1 subtypes in people living with HIV in Sicily, Italy, 2021–2023","authors":"Luca Pipitò , Marcello Trizzino , Chiara Mascarella , Sara Cannella , Roberta Gaudiano , Irene Ganci , Gaetano D'Alessandro , Benedetta Romanin , Maria Mercedes Santoro , Giovanni M. Giammanco , Antonio Cascio , Celestino Bonura","doi":"10.1016/j.jgar.2024.12.015","DOIUrl":"10.1016/j.jgar.2024.12.015","url":null,"abstract":"<div><h3>Objectives</h3><div>HIV-1 infection continues to be a significant public health concern, notwithstanding the expanded utilization of antiretroviral treatment (ART), due to the emergence of drug resistance. The prevalence of transmitted drug resistance remains uncertain, particularly concerning integrase inhibitors. This study aimed to assess the extent of HIV resistance in both ART-naïve and experienced individuals living with HIV (PLHIV) at the University Hospital in Palermo, Italy.</div></div><div><h3>Methods</h3><div>Genotyping and mutation analysis were performed on ART naïve and experienced PLHIV admitted from June 2021 to October 2023 by the NGS method. Mutations were detected by testing different NGS frequency cut-offs: ≥5 %, ≥10 %, and ≥20 %. Demographic, clinical, virological, and immunological data were retrospectively collected.</div></div><div><h3>Results</h3><div>Of the PLHIV, 85 (70 %) were ART-naïve, while 36 (30 %) were ART-experienced with virological failure. The main HIV-1 subtype was B (54 %), which was significantly associated with Italy-born (<em>P</em> < 0.001) and experienced PLHIV (<em>P</em> = 0.024). In the remaining cases, A1 (6 %), C (3 %), F1 (7 %), G (2 %), and Circulating Recombinant Forms (28 %) were reported. At least one mutation for a drug class was detected in 39.7 %, 45.4 %, and 53.7 % of cases at HIV-1 NGS thresholds of 20 %, 10 %, and 5 %, respectively. Drug resistance was found in 18.2 %, 25.6 %, and 33.0 %, by NGS cut-off of 20 %, 10 %, and 5 % respectively. The lowering of NGS cut-offs mainly increased the rates of integrase strand transfer inhibitor resistance. For overall resistance, no difference was observed between B and non-B subtypes for any NGS cut-offs.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 68-76"},"PeriodicalIF":3.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan Manuel de Mendieta , Denise De Belder , Nathalie Tijet , Barbara Ghiglione , Roberto G. Melano , Melina Rapoport , Pablo Power , Adriana Di Bella , Estefanía Biondi , Fernando Pasterán , Alejandra Corso , Sonia A. Gomez
{"title":"Novel allelic variants of blaOXA-48-like carried on IncN2 and IncC2 plasmids isolated from clinical cases in Argentina: In vivo emergence of blaOXA-567","authors":"Juan Manuel de Mendieta , Denise De Belder , Nathalie Tijet , Barbara Ghiglione , Roberto G. Melano , Melina Rapoport , Pablo Power , Adriana Di Bella , Estefanía Biondi , Fernando Pasterán , Alejandra Corso , Sonia A. Gomez","doi":"10.1016/j.jgar.2024.12.008","DOIUrl":"10.1016/j.jgar.2024.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>The OXA-48-like enzymes have the capacity to hydrolyse carbapenems and are members of class D β-lactamases that are primarily detected in <em>Enterobacterales</em>. The allelic variant <em>bla</em><sub>OXA-163</sub>, which has low hydrolytic activity towards carbapenems, was detected in Argentina in 2011 and has spread successfully since then, giving sporadic origin to novel local variants. The aim of this study was to analyse the phenotypic profile and dissemination strategies of two novel OXA enzymes, <em>bla</em><sub>OXA-438</sub> and <em>bla</em><sub>OXA-567</sub>, located in <em>Escherichia coli</em> M17224 and <em>Klebsiella pneumoniae</em> M21014, respectively, isolated from two paediatric patients.</div></div><div><h3>Methods</h3><div>Minimum inhibitory concentration measurements were performed to determine the phenotypic profile of the clinical isolates, transconjugants and transformant cells. Biparental conjugation, PCR, Sanger and whole-genome sequencing were performed to determine the complete genetic characteristics of the plasmids.</div></div><div><h3>Results</h3><div>Both isolates were found to be resistant to carbapenems and susceptible to ceftriaxone. <em>bla</em><sub>OXA-438</sub> was located on a 69-kb IncN<sub>2</sub> plasmid, while <em>bla</em><sub>OXA-567</sub> was found on a 175-Kb IncC<sub>2</sub> plasmid, both transferable by biparental conjugation. The close genetic environment of the <em>bla</em><sub>OXA</sub> genes suggests a common origin likely involving mobile genetic elements. Finally, the clinical case of M21014 revealed that the patient had previous infections with two genetically related <em>K. pneumoniae</em> ST6838 that carried <em>bla</em><sub>OXA-163</sub> on an IncC<sub>2</sub> plasmid with equal size and genetic hallmarks to that of M21014, providing strong evidence for the intra-patient emergence of <em>bla</em><sub>OXA-567.</sub></div></div><div><h3>Conclusions</h3><div>This research underscores the need for ongoing surveillance and integral studies to understand the emergence, biochemistry and dissemination capacity of OXA enzymes with the overarching aim to halt their spread.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 88-95"},"PeriodicalIF":3.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of molecular markers of chloroquine resistance in malaria parasites in East Africa: A systematic review and meta-analysis","authors":"Wagaw Abebe , Amare Mekuanint , Zelalem Asmare , Dagmawi Woldesenbet , Yenesew Mihret , Abebaw Setegn , Tadele Emagneneh","doi":"10.1016/j.jgar.2024.12.019","DOIUrl":"10.1016/j.jgar.2024.12.019","url":null,"abstract":"<div><h3>Background</h3><div>Malaria is a serious global public health problem, which is caused by genus <em>Plasmodium</em>. Resistance of the human malaria parasite to antimalarial drugs is a public health concern in malaria endemic countries. Chloroquine is resistant for both <em>P. vivax</em> and <em>P. falciparum</em>. Chloroquine resistance is understood throughout all of Africa's <em>P. falciparum</em> endemic regions. Molecular markers play a crucial role in tracking and understanding the prevalence of antimalarial drug resistance. Currently, there is inadequate information on the prevalence of molecular markers of chloroquine resistance in malaria parasites.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis aimed to determine the pooled prevalence of molecular markers of chloroquine resistance in malaria parasites in East Africa.</div></div><div><h3>Methods</h3><div>Systematic search was performed to retrieve articles from PubMed, Scopus, Science Direct, and the Google Scholar search engine. Twenty potential studies that provided important data on markers of chloroquine resistance in malaria parasites were systematically reviewed and analyzed. Five antimalarial drug resistance markers of chloroquine resistance were extracted separately into Microsoft Excel and analyzed using STATA 17.0. The Inverse of variance (I<sup>2</sup>) was done to evaluate heterogeneity across studies. The funnel plot and the Egger's test were used to determine the existence or absence of publication bias. A trim-and-fill meta-analysis was carried out to generate a bias-adjusted effect estimate. A random effect model was used to determine the pooled prevalence of molecular markers associated with chloroquine resistance in malaria parasites. Subgroup analysis was performed based on country and year of publication.</div></div><div><h3>Results</h3><div>A total of 20 studies were included for this systematic review and meta-analysis. The molecular markers like K76T, 76T, N86Y, Y184F, and 86Y were selected for meta-analysis. From this meta-analysis, the pooled prevalence of K76T, 76T, N86Y, Y184F, and 86Y was 34.5%, 47.3%, 43.8%, 58.3%, and 29.2%, respectively. After adjusting for publication bias, the estimated pooled prevalence of K76T, 76T, N86Y, Y184F, and 86Y were 34.5%, 47.3%, 43.8%, 58.3%, and 29.2%, respectively. Meta-analysis showed a significant difference in all molecular marker prevalence like K76T and 86Y among studies on year of publication except 76T, N86Y, and Y184F. In addition, the meta-analysis showed a significant difference in all molecular marker prevalence like K76T, 76T, N86Y, Y184F, and 86Y among studies at the country level.</div></div><div><h3>Conclusions</h3><div>The findings of this systematic review and meta-analysis concerning the molecular markers of chloroquine resistance of malaria parasites in East Africa revealed a significant prevalence of antimalarial drug resistance markers of chloroquine. As a result","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 117-137"},"PeriodicalIF":3.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intestinal colonisation of vancomycin-resistant enterococci among patients with cancer at Jimma University Medical Center, Ethiopia: A comparative cross-sectional study","authors":"Amanuel Teferi , Rahel Tamrat , Diriba Fufa , Kasahun Gorems , Tadele Akeba Diriba , Mulualem Tadesse","doi":"10.1016/j.jgar.2024.12.025","DOIUrl":"10.1016/j.jgar.2024.12.025","url":null,"abstract":"<div><h3>Objective</h3><div>Vancomycin-resistant enterococci (VRE) pose a major threat in hospital settings. Patients with cancer are at a higher risk of hospital-acquired infections such as VRE. This study aimed to determine the intestinal colonisation rate of VRE in patients with cancer at Jimma University Medical Center, southwest Ethiopia.</div></div><div><h3>Methods</h3><div>A comparative cross-sectional study was conducted prospectively from April to September 2021 at Jimma University Medical Center on 113 patients with cancer. An equal number of apparently healthy individuals were included for comparison. Stool samples were collected from both patients with cancer and apparently healthy individuals, then cultured on bile esculin azide agar. Vancomycin resistance was determined by minimum inhibitory concentration and disk diffusion method, whereas antibiotic susceptibility to other antibiotics was performed by disk diffusion method. Data were entered into Epidata v. 4.6.0.6 and analysed by SPSS v. 26.</div></div><div><h3>Results</h3><div>The overall colonisation rate of <em>Enterococcus</em> species was 76.9% (87/113) in patients with cancer and 80.5% (91/113) in apparently healthy individuals, with no statistically significant difference. However, the intestinal colonisation rate of VRE was higher in patients with cancer (12.6%; 11/87) compared with apparently healthy individuals (4.4%, 4/91). VRE isolates showed the highest resistance to tetracycline (66.7%) and the lowest resistance to chloramphenicol (13.3%). Multidrug resistance was observed in more than half (66.7%; 10/15) of the VRE isolates.</div></div><div><h3>Conclusions</h3><div>The intestinal colonisation rate by VRE was higher in patients with cancer compared with healthy individuals. Regular screening for VRE colonisation, along with improved infection-prevention practices, are vital to reduce the risk of VRE infections.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 144-150"},"PeriodicalIF":3.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zannat Kawser , Sushmita Sridhar , Sanchita Kar , Tanbir Habib , Sharmin Akter Mukta , Kasrina Azad , Neyamul Hasan , Umme Kulsum , Abu Bakar Siddik , Saikt Rahman , Nusrat Noor Tanni , Maherun Nesa , Ashlee M. Earl , Colin J. Worby , Sarah E. Turbett , SM Shamsuzzaman , Jason B Harris , Firdausi Qadri , Regina C LaRocque
{"title":"Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, Bangladesh","authors":"Zannat Kawser , Sushmita Sridhar , Sanchita Kar , Tanbir Habib , Sharmin Akter Mukta , Kasrina Azad , Neyamul Hasan , Umme Kulsum , Abu Bakar Siddik , Saikt Rahman , Nusrat Noor Tanni , Maherun Nesa , Ashlee M. Earl , Colin J. Worby , Sarah E. Turbett , SM Shamsuzzaman , Jason B Harris , Firdausi Qadri , Regina C LaRocque","doi":"10.1016/j.jgar.2024.12.016","DOIUrl":"10.1016/j.jgar.2024.12.016","url":null,"abstract":"<div><h3>Background</h3><div><em>Klebsiella pneumoniae</em> (Kpn), a WHO priority pathogen with high rates of antimicrobial resistance (AMR), has emerged as a leading cause of hospital acquired pneumonia and neonatal sepsis.</div></div><div><h3>Objective</h3><div>We aimed to define the clinical characteristics of a cohort of patients with Kpn infection in Dhaka, Bangladesh and to perform phenotypic and genetic characterization of the associated isolates.</div></div><div><h3>Methods</h3><div>We retrospectively extracted clinical data about patients at Dhaka Medical College Hospital from whom <em>Klebsiella spp</em> was isolated from a clinical specimen collected between February and September 2022. We used standard microbiologic techniques to evaluate AMR and whole-genome sequencing (WGS) to assess dominant lineages, common capsular (K) and O-polysaccharide (O) antigen types, and AMR and virulence genes.</div></div><div><h3>Results</h3><div>Ninety-eight patients were included, with diagnoses of pneumonia (38/98, 39 %), wound infection (29/98, 31 %), urinary tract infection (29/98, 31 %) and bacteremia (2/98, 2 %). We tested isolates for susceptibility to eight classes of antibiotics. Of the 98 isolates, 41 % were multidrug resistant (MDR), 15 % were extensively drug resistant (XDR), and 16 % were pan-drug resistant (PDR). Three isolates (3 %) were resistant to polymyxin B. Outcome data were available for 46 patients; 4 patients (8 %) died from infections caused by PDR (<em>n</em> = 2), XDR (<em>n</em> = 1), and MDR isolates (<em>n</em> = 1). WGS revealed a high degree of genomic diversity, with multiple sequence types (STs), O-types and K-types represented; ST16:K81:OL101 and ST43:K30:O1 were the most prevalent.</div></div><div><h3>Conclusion</h3><div>Our findings suggest alarming levels of AMR among Kpn isolates in Bangladesh and a critical need for improved treatment modalities and vaccine development.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"41 ","pages":"Pages 52-58"},"PeriodicalIF":3.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}