Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 210, Issue 5, Pages 803-813Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiu157
Keywords
Klebsiella pneumoniae; virulence; adjuvant therapy; carbapenem resistance
Categories
Funding
- NIH [U54-AI057158, R01-A1059681]
- Department of Energy [DE-FG02-93ER-20097]
- National Institutes of Health [1R01AI090155]
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Background. Novel therapies are urgently needed to treat carbapenem-resistant Klebsiella pneumoniae (CR-Kp)-mediated infection, which constitute a major health threat in the United States. In order to assess if it is feasible to develop anticapsular antibodies as a potential novel therapy, it is crucial to first systematically characterize capsular polysaccharide (CPS) and virulence traits in these strains. Methods. Forty CR-Kp were genotyped by pulsed field gel electrophoresis, multilocus sequence typing (MLST), and molecular capsule typing (C-patterns and wzi sequencing). Their biofilm formation, serum resistance, macrophage-mediated killing, and virulence in Galleria mellonella were compared. MAb (1C9) was generated by co-immunization with 2 CPSs, and cross-reactivity was investigated. Results. MLST assigned 80% of CR-Kp isolates to the ST258-clone. Molecular capsule typing identified new C-patterns, including C200/wzi-154, which was widely represented and associated with bla(KPC-3)-bearing strains. Heterogeneity was detected in biofilm formation and macrophage-mediated killing. Differences in serum resistance correlated with virulence in G. mellonella. ST258 strains carrying bla(KPC-3) were less virulent than those with bla(KPC-2). MAb 1C9 cross-reacted with 58% of CR-Kp CPSs. Conclusions. CR-Kp ST258 strains exhibit variability of virulence-associated traits. Differences were associated with the type of KPC gene and CPS. Identification of cross-reacting anti-CPS mAbs encourages their development as adjunctive therapy.
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