Multidrug-resistant Klebsiella pneumoniae: a retrospective study in Manaus, Brazil
Rafael Nakamura-Silva1, Louise Cerdeira2,3, Mariana Oliveira-Silva1
1Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, UNAERP, Bloco J, Laboratório 1. Av. Costábile Romano, 2201 Ribeirânia, Ribeirão Preto, São Paulo, 14096-900, Brazil.
Abstract:
Klebsiella pneumoniae is an opportunistic pathogen that can cause several infections, mainly in hospitalised or immunocompromised individuals. The spread of K. pneumoniae emerging virulent and multidrug-resistant clones is a worldwide concern and its identification is crucial to control these strains especially in hospitals. This article reports data related to multi-resistant K. pneumoniae strains, isolated from inpatients in the city of Manaus, Brazil, harbouring virulence and antimicrobial-resistance genes, including high-risk international clones belonging to clonal group (CG) 258. Twenty-one strains isolated from different patients admitted to four hospitals in the city of Manaus, located in the state of Amazonas, Northern Brazil (Amazon Rainforest region) were evaluated. The majority of strains (61.9% n = 13) were classified as multidrug-resistant (MDR), and five strains (23.8%) as extensively drug-resistant (XDR). Several virulence and antimicrobial-resistance genes were found among the strains and eight strains (38.1%) presented the hyper-mucoviscous phenotype. MLST analysis demonstrated a great diversity of STs among the strains, totaling 12 different STs (ST11, ST23, ST198, ST277, ST307, ST340, ST378, ST462, ST502, ST3991, ST3993 and ST5209). Three of these (ST11, ST23 and ST340) belong to CG258.
Insights
Multidrug-resistant Klebsiella pneumoniae strains, including high-risk clones, were identified in Manaus, Brazil. This finding highlights the urgent need for enhanced surveillance and control measures against these dangerous pathogens in healthcare settings.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Klebsiella pneumoniae is an opportunistic pathogen causing infections in vulnerable individuals.
- The global spread of virulent, multidrug-resistant (MDR) K. pneumoniae strains is a significant public health concern.
- Effective identification and control of these strains are critical, particularly within hospital environments.
Purpose of the Study:
- To characterize multidrug-resistant Klebsiella pneumoniae strains isolated from hospitalized patients in Manaus, Brazil.
- To identify the presence of virulence and antimicrobial-resistance genes, as well as high-risk international clones.
- To assess the prevalence of the hyper-mucoviscous phenotype and genetic diversity.
Main Methods:
- Isolation and characterization of K. pneumoniae strains from inpatients across four hospitals in Manaus.
- Antimicrobial susceptibility testing to determine MDR and extensively drug-resistant (XDR) classifications.
- Molecular analysis, including Multi-Locus Sequence Typing (MLST) and detection of specific genes.
Main Results:
- Twenty-one K. pneumoniae strains were analyzed, with 61.9% classified as MDR and 23.8% as XDR.
- Several virulence and antimicrobial-resistance genes were detected.
- Twelve distinct Sequence Types (STs) were identified, including ST11, ST23, and ST340, which belong to the high-risk clonal group (CG) 258. Eight strains (38.1%) exhibited the hyper-mucoviscous phenotype.
Conclusions:
- The study identified multidrug-resistant and extensively drug-resistant Klebsiella pneumoniae strains in Manaus, Brazil, including concerning international clones like CG258.
- The presence of virulence factors and resistance genes underscores the threat posed by these pathogens.
- Findings emphasize the need for robust surveillance and infection control strategies to combat the spread of resistant K. pneumoniae in healthcare settings.
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