Genetic factors related to the widespread dissemination of ST11 extensively drug-resistant carbapenemase-producing Klebsiella pneumoniae strains within hospital.

Li, D-X; Zhai, Y; Zhang, Z; Guo, Y-T; Wang, Z-W; He, Z-L; Hu, S-N; Chen, Y-S; Kang, Y; Gao, Z-C

Genetic factors related to the widespread dissemination of ST11 extensively drug-resistant carbapenemase-producing Klebsiella pneumoniae strains within hospital.

Li, D-X Zhai, Y Zhang, Z Guo, Y-T Wang, Z-W He, Z-L Hu, S-N Chen, Y-S Kang, Y Gao, Z-C

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Publisher:: Ovid Technologies (Wolters Kluwer Health)
Publication Type:: Journal Article
Citation:: Chinese medical journal, 2020, 133, (21), pp. 2573-2585
Issue Date:: 2020-11

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Field	Value	Language
dc.contributor.author	Li, D-X
dc.contributor.author	Zhai, Y
dc.contributor.author	Zhang, Z
dc.contributor.author	Guo, Y-T
dc.contributor.author	Wang, Z-W
dc.contributor.author	He, Z-L
dc.contributor.author	Hu, S-N
dc.contributor.author	Chen, Y-S
dc.contributor.author	Kang, Y
dc.contributor.author	Gao, Z-C
dc.date.accessioned	2021-06-15T06:36:32Z
dc.date.available	2021-06-15T06:36:32Z
dc.date.issued	2020-11
dc.identifier.citation	Chinese medical journal, 2020, 133, (21), pp. 2573-2585
dc.identifier.issn	0366-6999
dc.identifier.issn	2542-5641
dc.identifier.uri	http://hdl.handle.net/10453/149533
dc.description.abstract	<h4>Background</h4>Carbapenemase-producing Klebsiella pneumoniae (CP-Kp) poses distinct clinical challenges due to extensively drug resistant (XDR) phenotype, and sequence type (ST) 11 is the most dominant blaKPC-2-bearing CP-Kp clone in China. The purpose of this current retrospective study was to explore the genetic factors associated with the success of XDR CP-Kp ST11 strains circulated in the intensive care unit (ICU) of a Chinese tertiary hospital.<h4>Methods</h4>Six ST11 XDR CP-Kp strains were identified between May and December 2014 and validated by minimum inhibitory concentration examination, polymerase chain reaction, and pyrosequencing. The six ST11 XDR CP-Kp, as well as three multi-drug resistant (MDR) and four susceptible strains, were sequenced using single-molecule real-time method. Comprehensively structural and functional analysis based on comparative genomics was performed to identify genomic characteristics of the XDR ST11 CP-Kp strains.<h4>Results</h4>We found that ST11 XDR blaKPC-2-bearing CP-Kp strains isolated from inpatients spread in the ICU of the hospital. Functionally, genes associated with information storage and processing of the ST11 XDR CP-Kp strains were more abundant than those of MDR and susceptible strains, especially genes correlative with mobile genetic elements (MGEs) such as transposons and prophages. Structurally, eleven large-scale genetic regions taken for the unique genome in these ST11 XDR CP-Kp strains were identified as MGEs including transposons, integrons, prophages, genomic islands, and integrative and conjugative elements. Three of them were located on plasmids and eight on chromosomes; five of them were with antimicrobial resistance genes and eight with adaptation associated genes. Notably, a new blaKPC-2-bearing ΔΔTn1721-blaKPC-2 transposon, probably transposed and truncated from ΔTn1721-blaKPC-2 by IS903D and ISKpn8, was identified in all six ST11 XDR CP-Kp strains.<h4>Conclusion</h4>Our findings suggested that together with clonal spread, MGEs identified uniquely in the ST11 XDR CP-Kp strains might contribute to their formidable adaptability, which facilitated their widespread dissemination in hospital.
dc.format	Print
dc.language	eng
dc.publisher	Ovid Technologies (Wolters Kluwer Health)
dc.relation.ispartof	Chinese medical journal
dc.relation.isbasedon	10.1097/cm9.0000000000001101
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology, 1199 Other Medical and Health Sciences
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.classification	General & Internal Medicine
dc.subject.mesh	Humans
dc.subject.mesh	Klebsiella pneumoniae
dc.subject.mesh	Klebsiella Infections
dc.subject.mesh	beta-Lactamases
dc.subject.mesh	Bacterial Proteins
dc.subject.mesh	Pharmaceutical Preparations
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Electrophoresis, Gel, Pulsed-Field
dc.subject.mesh	Microbial Sensitivity Tests
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Hospitals
dc.subject.mesh	China
dc.subject.mesh	Multilocus Sequence Typing
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Bacterial Proteins
dc.subject.mesh	China
dc.subject.mesh	Electrophoresis, Gel, Pulsed-Field
dc.subject.mesh	Hospitals
dc.subject.mesh	Humans
dc.subject.mesh	Klebsiella Infections
dc.subject.mesh	Klebsiella pneumoniae
dc.subject.mesh	Microbial Sensitivity Tests
dc.subject.mesh	Multilocus Sequence Typing
dc.subject.mesh	Pharmaceutical Preparations
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	beta-Lactamases
dc.title	Genetic factors related to the widespread dissemination of ST11 extensively drug-resistant carbapenemase-producing Klebsiella pneumoniae strains within hospital.
dc.type	Journal Article
utslib.citation.volume	133
utslib.location.activity	China
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.for	1199 Other Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/DVC (Teaching and Learning)
utslib.copyright.status	open_access	*
dc.date.updated	2021-06-15T06:36:28Z
pubs.issue	21
pubs.publication-status	Published
pubs.volume	133
utslib.citation.issue	21

Abstract:

Background

Carbapenemase-producing Klebsiella pneumoniae (CP-Kp) poses distinct clinical challenges due to extensively drug resistant (XDR) phenotype, and sequence type (ST) 11 is the most dominant blaKPC-2-bearing CP-Kp clone in China. The purpose of this current retrospective study was to explore the genetic factors associated with the success of XDR CP-Kp ST11 strains circulated in the intensive care unit (ICU) of a Chinese tertiary hospital.

Methods

Six ST11 XDR CP-Kp strains were identified between May and December 2014 and validated by minimum inhibitory concentration examination, polymerase chain reaction, and pyrosequencing. The six ST11 XDR CP-Kp, as well as three multi-drug resistant (MDR) and four susceptible strains, were sequenced using single-molecule real-time method. Comprehensively structural and functional analysis based on comparative genomics was performed to identify genomic characteristics of the XDR ST11 CP-Kp strains.

Results

We found that ST11 XDR blaKPC-2-bearing CP-Kp strains isolated from inpatients spread in the ICU of the hospital. Functionally, genes associated with information storage and processing of the ST11 XDR CP-Kp strains were more abundant than those of MDR and susceptible strains, especially genes correlative with mobile genetic elements (MGEs) such as transposons and prophages. Structurally, eleven large-scale genetic regions taken for the unique genome in these ST11 XDR CP-Kp strains were identified as MGEs including transposons, integrons, prophages, genomic islands, and integrative and conjugative elements. Three of them were located on plasmids and eight on chromosomes; five of them were with antimicrobial resistance genes and eight with adaptation associated genes. Notably, a new blaKPC-2-bearing ΔΔTn1721-blaKPC-2 transposon, probably transposed and truncated from ΔTn1721-blaKPC-2 by IS903D and ISKpn8, was identified in all six ST11 XDR CP-Kp strains.

Conclusion

Our findings suggested that together with clonal spread, MGEs identified uniquely in the ST11 XDR CP-Kp strains might contribute to their formidable adaptability, which facilitated their widespread dissemination in hospital.

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http://hdl.handle.net/10453/149533