Genomic Characterization of NDM-1 Harboring Extensively-Drug Resistance Klebsiella pneumoniae Isolate From...

Area of Science:

• Medical Microbiology
• Genomics
• Infectious Diseases

Background:

• Carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains, especially those producing New Delhi metallo-beta-lactamase (NDM), pose a significant global health risk.
• The emergence of extensively drug-resistant (XDR) strains in intensive care units (ICUs) is a growing concern, particularly in patients with severe infections like COVID-19.

Purpose of the Study:

• To perform a comprehensive genomic analysis of an NDM-1 producing CR-KP strain isolated from a COVID-19 patient in the ICU.
• To characterize the antimicrobial resistance profile and genetic makeup of the identified CR-KP strain.

Main Methods:

• Whole genome sequencing was employed for genomic analysis of the K. pneumoniae isolate.
• Antimicrobial susceptibility testing was conducted using the VITEK 2 system to determine minimum inhibitory concentrations (MICs) for 15 antibiotics.
• Multilocus sequence typing (MLST) was performed to identify the sequence type (ST) of the isolate.

Main Results:

• The CRKP-51 strain, isolated from bronchoalveolar lavage fluid, was identified as XDR, resistant to all tested antibiotics except tigecycline.
• The strain exhibited high resistance to sulfamethoxazole-trimethoprim (SXT), nitrofurantoin (NIT), and piperacillin-tazobactam (TZP).
• Genomic analysis revealed the strain belongs to ST15 and harbors multiple resistance genes, including blaNDM-1, armA, msrE, mphE, and others, located on an IncHI1B plasmid.

Conclusions:

• High-risk K. pneumoniae clones like ST15 are increasingly linked to antimicrobial resistance and XDR strain emergence in ICUs.
• The study underscores the importance of monitoring local epidemiology for effective antimicrobial stewardship programs, given the global dissemination of NDM enzymes via various plasmid types.