期刊
ANTIBIOTICS-BASEL
卷 10, 期 3, 页码 -出版社
MDPI
DOI: 10.3390/antibiotics10030284
关键词
Klebsiella pneumoniae; multidrug resistance; polymyxins; whole-genome sequencing
资金
- Universidad El Bosque [PCI 2018-10106]
A study in Colombia identified clonal dissemination of polymyxin and carbapenem-resistant K. pneumoniae isolates, mainly associated with CG258 and bla(KPC-3), highlighting limited therapeutic options for carbapenem-resistant strains.
Polymyxin resistance in Klebsiella pneumoniae has been attributed to mutations in mgrB, phoPQ, pmrAB, and crrAB and to the presence of mcr plasmid-mediated genes. Herein, we describe the molecular characteristics of 24 polymyxin- and carbapenem-resistant K. pneumoniae isolates recovered from six Colombian cities between 2009 and 2019. Minimum inhibitory concentrations (MICs) to polymyxin were confirmed by broth microdilution, and whole-genome sequencing was performed to determine sequence type, resistome, and mutations in the genes related to polymyxin resistance, as well the presence of mcr. The results showed high-level resistance to polymyxin (MICs >= 4 mu g/mL). bla(KPC-3) was present in the majority of isolates (17/24; 71%), followed by bla(KPC-2) (6/24; 25%) and bla(NDM-1) (1/24; 4%). Most isolates belonged to the CG258 (17/24; 71%) and presented amino acid substitutions in PmrB (22/24; 92%) and CrrB (15/24; 63%); mutations in mgrB occurred in only five isolates (21%). Additional mutations in pmrA, crrA, and phoPQ nor any of the mcr resistance genes were identified. In conclusion, we found clonal dissemination of polymyxin and carbapenem-resistant K. pneumoniae isolates in Colombia, mainly associated with CG258 and bla(KPC-3). Surveillance of this multidrug-resistant clone is warranted due to the limited therapeutic options for the treatment of carbapenem-resistant K. pneumoniae infections.
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