Pandrug-resistant Klebsiella pneumoniae isolated from Ukrainian war victims are hypervirulent

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES Journal of Infection Pub Date : 2024-10-11 DOI:10.1016/j.jinf.2024.106312

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Abstract

Objectives

Carbapenem- and colistin-resistant Klebsiella pneumoniae were isolated from war victims treated in hospitals in Ukraine. The question was whether these pandrug-resistant K. pneumoniae are pathogenic and capable of causing disease in a broader context.

Methods

Klebsiella pneumoniae clinical isolates (n = 37) were tested for antibiotic resistance and subjected to whole-genome sequencing (WGS). In addition, their pathogenicity was tested by serum resistance and two separate animal models.

Results

Isolates belonging to the sequence types (ST) 23, 147, 307, 395, and 512 were found to harbor resistance genes against carbapenems and cephalosporins. Nine isolates carried point mutations in pmrB and phoP genes associated with colistin resistance. All bacteria were equipped with multiple virulence genes, and the colistin-resistant isolates each carried 10 different genes. Colistin-resistant K. pneumoniae were more serum-resistant, more virulent against G. mellonella larvae, and displayed an increased survival in mice compared to colistin-susceptible bacteria. The iucA, peg-344, rmpA, rmpC, and rmpD genes were associated with increased virulence in animals.

Conclusions

Pandrug-resistant K. pneumoniae in Ukraine are hypervirulent and retain their pathogenicity, highlighting the need to prevent disseminated spread.

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从乌克兰战争受害者体内分离出的耐潘生菌肺炎克雷伯氏菌具有高病毒性。

目的：从在乌克兰医院接受治疗的战争受害者体内分离出抗碳青霉烯类和抗大肠杆菌的肺炎克雷伯氏菌。问题是这些对潘生丁耐药的肺炎克雷伯菌是否具有致病性，是否能在更广泛的范围内致病：方法：对肺炎克雷伯菌临床分离株（n = 37）进行抗生素耐药性检测，并进行全基因组测序（WGS）。此外，还通过血清耐药性和两种不同的动物模型检测了它们的致病性：结果：发现属于序列类型（ST）23、147、307、395 和 512 的分离株携带对碳青霉烯类和头孢菌素的耐药基因。九个分离菌株的 pmrB 和 phoP 基因携带与可乐定耐药性相关的点突变。所有细菌都带有多种毒力基因，耐秋水仙素的分离株各带有 10 种不同的基因。与对秋水仙碱敏感的细菌相比，耐秋水仙碱的肺炎克氏菌对血清的抵抗力更强，对G. mellonella幼虫的毒力更强，在小鼠体内的存活率更高。iucA、peg-344、rmpA、rmpC 和 rmpD 基因与动物毒力增强有关：结论：乌克兰的耐潘生丁肺炎克氏菌具有很强的致病力，并能保持其致病性，因此需要防止其传播。

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.