4.6 Article

Genetic Diversity of Polymyxin-Resistance Mechanisms in Clinical Isolates of Carbapenem-Resistant Klebsiella pneumoniae: a Multicenter Study in China

相关参考文献

注意:仅列出部分参考文献,下载原文获取全部文献信息。
Article Infectious Diseases

Epidemiology and genotypic characteristics of carbapenem resistant Enterobacterales in Henan, China: a multicentre study

Nan Jing et al.

Summary: The study identified widespread dissemination of CRKP-ST11 in the analyzed 18 hospitals in Henan province, with significant differences in CRKP and CREC between secondary and tertiary hospitals. The emergence of colistin-resistant CRKP carrying the plasmid-mediated mcr-1 gene raises serious concerns due to limited treatment options.

JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE (2022)

Article Microbiology

Prevalence of insertion sequence elements in plasmids relating to mgrB gene disruption causing colistin resistance in Klebsiella pneumoniae

Stephen Mark Edward Fordham et al.

Summary: Colistin is a last resort antibiotic for treating carbapenemase producing Klebsiella pneumoniae. The insertion of IS elements into the mgrB gene is a mechanism that causes colistin resistance. Plasmids carrying IS elements are common in K. pneumoniae, with ISKpn25 being mostly carried by IncFIB(pQil) plasmids, while ISKpn26 and ISKpn14 are often associated with IncFII(pHN7A8) plasmids. ISKpn25 is identified in 26 out of 34 countries that contain any of the IS elements, while ISKpn26, ISKpn14, and IS903B are most frequently found in China. Plasmids carrying ISKpn25, ISKpn14, and ISKpn26 have a higher count of carbapenemase genes compared to IS903B-carrying plasmids. IS903B-bearing plasmids have a higher count of environmental source isolations compared to ISKpn25, ISKpn14, and ISKpn26 bearing plasmids. The presence of carbapenemase in combination with IS elements could lead to an extensively drug-resistant profile in K. pneumoniae, limiting treatment options.

MICROBIOLOGYOPEN (2022)

Article Infectious Diseases

A phylogenomic approach for the analysis of colistin resistance-associated genes in Klebsiella pneumoniae , its mutational diversity and implications for phenotypic resistance

Rita Elias et al.

Summary: This study analyzes the mutational diversity of 22 genes associated with colistin resistance in 140 clinical isolates of Klebsiella pneumoniae. Novel mutations potentially involved in colistin resistance are identified. However, most of the mutations previously associated with colistin resistance are clade-associated and present in susceptible isolates, showing no correlation with colistin resistance.

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS (2022)

Article Infectious Diseases

A 12 year experience of colistin resistance in Klebsiella pneumoniae causing neonatal sepsis: two-component systems, efflux pumps, lipopolysaccharide modification and comparative phylogenomics

Sharmi Naha et al.

Summary: This study aimed to understand the susceptibility trend and molecular mechanisms of colistin resistance in neonatal isolates over a 12 year period. The results showed that colistin-resistant Klebsiella pneumoniae had multiple mechanisms of resistance, including overexpression of two-component systems and AcrAB-TolC pump and its regulators. The presence of strains with dual carbapenemases causing sepsis in neonates is alarming.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2022)

Article Microbiology

Whole Genome Sequence Analysis of Multidrug Resistant Escherichia coli and Klebsiella pneumoniae Strains in Kuwait

Ola H. Moghnia et al.

Summary: The spread of carbapenem-resistant E. coli and K. pneumoniae is a global concern. This study aimed to investigate the genetic characteristics and variations of multidrug resistant isolates. Whole genome sequencing was carried out on eight carbapenem-resistant isolates, and various resistance genes were detected. This research is important for understanding and combating antimicrobial resistance.

MICROORGANISMS (2022)

Article Immunology

Convergence of MCR-8.2 and Chromosome-Mediated Resistance to Colistin and Tigecycline in an NDM-5-Producing ST656 Klebsiella pneumoniae Isolate From a Lung Transplant Patient in China

Jiankang Zhao et al.

Summary: In this study, we identified and characterized the first NDM-5 and MCR-8.2 co-harboring ST656 Klebsiella pneumoniae clinical isolate. This isolate exhibited chromosomal gene-mediated resistance to colistin and tigecycline, and we analyzed the acquired resistance genes and mutations associated with these resistances. KP32558 was identified as a pan-drug resistant bacteria belonging to ST656, and it carried plasmid-encoded blaNDM-5 and mcr-8.2 genes.

FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY (2022)

Article Microbiology

Characterization of a Plasmid-Encoded Resistance-Nodulation Division Efflux Pump in Klebsiella pneumoniae and Klebsiella quasipneumoniae from Patients in China

Ruowen He et al.

Summary: The study identified two MDR Klebsiella pneumoniae isolates carrying mcr-1 from patients with urinary tract infections, and one MDR Klebsiella quasipneumoniae isolate carrying tmexCD1-toprJ1 from a patient with bloodstream infection. The addition of an efflux pump inhibitor significantly reduced tigecycline resistance in these isolates. Additionally, a plasmid carrying tmexCD1-toprJ1 was successfully transferred via conjugation from K. quasipneumoniae to Escherichia coli J53 for further analysis.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

Article Immunology

Clones and Clusters of Antimicrobial-Resistant Klebsiella From Southwestern Nigeria

Ayorinde O. Afolayan et al.

Summary: The study identified known and novel Klebsiella pneumoniae lineages circulating in three hospitals in Southwest Nigeria, including multidrug-resistant ESBL producers. Carbapenemase-producing isolates remain rare in Nigerian hospitals. The value of genomic approaches in AMR surveillance for improving infection prevention and control was highlighted by retrospectively identifying outbreak clusters using WGS.

CLINICAL INFECTIOUS DISEASES (2021)

Article Immunology

High-Resolution Genomic Profiling of Carbapenem- Resistant Klebsiella pneumoniae Isolates: A Multicentric Retrospective Indian Study

Geetha Nagaraj et al.

Summary: This study provides insight into the genetic diversity of CRKP isolates in India, identifying multiple sequence types and the presence of antimicrobial resistance genes. It demonstrates the practical applicability of genomic surveillance in tracking the population dynamics of CRKP and emphasizes the importance of longitudinal surveillance of these transmissible lineages.

CLINICAL INFECTIOUS DISEASES (2021)

Article Infectious Diseases

RamA upregulates multidrug resistance efflux pumps AcrAB and OqxAB in Klebsiella pneumoniae

Qingqing Xu et al.

Summary: This study demonstrates that RamA can directly regulate the expression of multidrug resistance efflux pumps AcrAB and OqxAB in Klebsiella pneumoniae by binding to the promoter regions of both the acrAB and oqxAB operons.

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS (2021)

Review Pharmacology & Pharmacy

Rescuing the Last-Line Polymyxins: Achievements and Challenges

Sue C. Nang et al.

Summary: Antibiotic resistance is a major global health challenge, and polymyxins have been revived as a last-line therapeutic option for infections caused by multidrug-resistant Gram negative bacteria. Recent efforts have been made to elucidate the properties of polymyxins and develop scientifically based dosage regimens to ensure safe and effective use. Challenges remain in optimizing clinical use and discovering new-generation polymyxins to overcome toxicities and narrow therapeutic windows.

PHARMACOLOGICAL REVIEWS (2021)

Article Infectious Diseases

Insertion sequences disrupting mgrB in carbapenem-resistant Klebsiella pneumoniae strains in Brazil

Daniely Martins da Silva et al.

Summary: This study identified that the insertion mutations disrupting the mgrB gene in carbapenem-resistant Klebsiella pneumoniae mainly involved IS5 sequences, with the first observation of mgrB::ISSen4 (IS3) in CRKp.

JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE (2021)

Article Infectious Diseases

Ri sk factors and mechanisms of in vivo emergence of colistin resistance in carbapenem-resistant Klebsiella pneumoniae

Po-Han Huang et al.

Summary: This study investigated the risk factors and mechanisms for in vivo emergence of colistin resistance in CRKP, revealing colistin exposure as a significant factor predisposing to resistance. Alterations in the mgrB gene were identified as the predominant mechanism for emergent colistin resistance.

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS (2021)

Article Biotechnology & Applied Microbiology

Mutations in two component system (PhoPQ and PmrAB) in colistin resistant Klebsiella pneumoniae from North Indian tertiary care hospital

Pushpa Kumari Nirwan et al.

Summary: This study investigated the molecular basis of colistin resistance in Klebsiella pneumoniae and its clonal transmission in a North Indian tertiary care hospital. Results indicated that colistin resistance was mainly attributed to mutations in PhoPQ and PmrAB TCS genes, with different sequence types sharing a common ancestor and showing clonal transmission patterns. These findings will contribute to the formulation of effective strategies for infection prevention and antimicrobial development.

JOURNAL OF ANTIBIOTICS (2021)

Article Microbiology

Genotyping of paired KPC-producing Klebsiella pneumoniae isolates with and without divergent polymyxin B susceptibility profiles

Suely Carlos Ferreira Sampaio et al.

Summary: Polymyxins are primarily used to treat infections caused by carbapenem-resistant Klebsiella pneumoniae, with the main mechanism of acquired resistance being mutations in genes regulating lipopolysaccharide modification. This study found infections in patients caused by isolates resistant to polymyxins, potentially due to distinct clonal infections.

BRAZILIAN JOURNAL OF MICROBIOLOGY (2021)

Article Infectious Diseases

Genetic Alterations Associated with Polymyxin B Resistance in Nosocomial KPC-2-Producing Klebsiella pneumoniae from Brazil

Paola Amaral de Campos et al.

Summary: Genomic survey of clinical polymyxin-resistant K. pneumoniae reveals diverse genetic variations, including common deleterious mutations in PmrB (R256G), YciM (N212T), and AcrB (T598A), while mobile colistin resistance (mcr) genes were absent in all isolates. Overexpression of pmrC, pmrD, and kpnE genes was observed in polymyxin B-resistant isolates compared to susceptible ones, suggesting unknown mechanisms of polymyxin resistance in K. pneumoniae.

MICROBIAL DRUG RESISTANCE (2021)

Article Genetics & Heredity

Whole-genome sequence-informed MALDI-TOF MS diagnostics reveal importance of Klebsiella oxytoca group in invasive infections: a retrospective clinical study

Aline Cuenod et al.

Summary: This study analyzed a diverse selection of Klebsiella spp. isolates from various healthcare institutions, identifying group and species-specific differences in antibiotic resistance and pathogenicity. Using species-specific marker masses, eight Klebsiella species can be distinguished using MALDI-TOF MS. Klebsiella oxytoca group isolates were less likely to be resistant to 4th-generation cephalosporins compared to Klebsiella pneumoniae group isolates, and were more associated with invasive infections.

GENOME MEDICINE (2021)

Article Infectious Diseases

Molecular Mechanism of Polymyxin Resistance in Multidrug-Resistant Klebsiella pneumoniae and Escherichia coli Isolates from Henan Province, China: A Multicenter Study

Wenjuan Yan et al.

Summary: The study evaluated the prevalence and characteristics of polymyxin-resistant Klebsiella pneumoniae and Escherichia coli in Henan province, China. It was found that the polymyxin resistance rate was slightly higher in K. pneumoniae compared to E. coli, and mcr-1 was more commonly detected in E. coli than in K. pneumoniae. Additionally, the insertion of ISkpn14 into mgrB may play a key role in polymyxin resistance in K. pneumoniae in Henan.

INFECTION AND DRUG RESISTANCE (2021)

Article Immunology

Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China

Yongqiang Yang et al.

Summary: This study investigated 425 isolates of Klebsiella pneumoniae to clarify the characteristics of carbapenemase-encoding and virulent plasmids. The findings revealed the multifactorial impact of KPC-2 plasmids on the bacteria, potentially associated with nosocomial dissemination of multidrug-resistant isolates.

EMERGING MICROBES & INFECTIONS (2021)

Article Microbiology

Effects of Regulatory Network Organization and Environment on PmrD Connector Activity and Polymyxin Resistance in Klebsiella pneumoniae and Escherichia coli

Annie Chen et al.

Summary: This study explores the role of PmrD in modulating polymyxin resistance in Klebsiella pneumoniae and Escherichia coli. In K. pneumoniae, PmrD is not necessary for polymyxin resistance due to mgrB mutations, but contributes under conditions of low pH or intermediate iron concentrations. In E. coli, PmrD acts as a connector between PhoQ/PhoP and PmrB/PmrA, with activity depending on PmrB/PmrA stimulation or high activation of PhoQ/PhoP. These findings suggest that the role of the PmrD connector in modulating the polymyxin resistance network varies depending on the organism and environmental conditions associated with PmrB stimulation.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

Article Infectious Diseases

Contributions of insertion sequences conferring colistin resistance in Klebsiella pneumoniae

Tsung-Ying Yang et al.

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS (2020)

Article Microbiology

Amino Acid Substitutions of CrrB Responsible for Resistance to Colistin through CrrC in Klebsiella pneumoniae

Yi-Hsiang Cheng et al.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2016)

Article Microbiology

Genomic Characterization of Colistin Heteroresistance in Klebsiella pneumoniae during a Nosocomial Outbreak

Teysir Halaby et al.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2016)

Article Microbiology

Elucidation of the RamA Regulon in Klebsiella pneumoniae Reveals a Role in LPS Regulation

Shyamasree De Majumdar et al.

PLOS PATHOGENS (2015)

Article Infectious Diseases

The mgrB gene as a key target for acquired resistance to colistin in Klebsiella pneumoniae

Laurent Poirel et al.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2015)

Article Biotechnology & Applied Microbiology

Red recombinase assisted gene replacement in Klebsiella pneumoniae

Dong Wei et al.

JOURNAL OF INDUSTRIAL MICROBIOLOGY & BIOTECHNOLOGY (2012)

Article Microbiology

Klebsiella pneumoniae AcrAB Efflux Pump Contributes to Antimicrobial Resistance and Virulence

Emma Padilla et al.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2010)

Article Biochemistry & Molecular Biology

Secondary acylation of Klebsiella pneumoniae lipopolysaccharide contributes to sensitivity to antibacterial peptides

Abigail Clements et al.

JOURNAL OF BIOLOGICAL CHEMISTRY (2007)

Article Microbiology

Diversity and evolution of the class a chromosomal beta-lactamase gene in Klebsiella pneumoniae

S Hæggman et al.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2004)