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.

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.