Abstract
Multidrug-resistant Klebsiella pneumoniae (MDR Kp), in particular carbapenem-resistant Kp (CR-Kp), has become endemic in Italy, where alarming data have been reported on the spread of colistin-resistant CR-Kp (CRCR-Kp). During the period 2013–2014, 27 CRCR-Kp nosocomial strains were isolated within the Modena University Hospital Policlinico (MUHP) multidrug resistance surveillance program. We retrospectively investigated these isolates by whole-genome sequencing (WGS) analysis of the resistome, virulome, plasmid content, and core single nucleotide polymorphisms (cSNPs) in order to gain insights into their molecular epidemiology. The in silico WGS analysis of the resistome revealed the presence of genes, such as blaKPC, related to the phenotypically detected resistances to carbapenems. Concerning colistin resistance, the plasmidic genes mcr 1–9 were not detected, while known and new genetic variations in mgrB, phoQ, and pmrB were found. The virulome profile revealed the presence of type-3 fimbriae, capsular polysaccharide, and iron acquisition system genes. The detected plasmid replicons were classified as IncFIB(pQil), IncFIB(K), ColRNAI, IncX3, and IncFII(K) types. The cSNPs genotyping was consistent with the multi locus sequence typing (MLST) and with the distribution of mutations related to colistin resistance genes. In a nosocomial drug resistance surveillance program, WGS proved to be a useful tool for elucidating the spread dynamics of CRCR-Kp nosocomial strains and could help to limit their diffusion.
Highlights
Klebsiella pneumoniae (Kp) is a Gram-negative bacterium that can colonize or cause infections in hospitalized patients
Twenty-five strains were assigned to sequence type (ST) 512, and two strains were assigned to ST258 (Table 1)
Due to the growing importance of Multidrug-resistant Klebsiella pneumoniae (MDR Kp), a fast and accurate identification and typing of pathogens is essential for effective surveillance and outbreak detection
Summary
Klebsiella pneumoniae (Kp) is a Gram-negative bacterium that can colonize or cause infections in hospitalized patients. Multidrug-resistant (MDR) Kp strains show high-level resistance to β-lactams, aminoglycosides, quinolones, tigecycline, and colistin. The carbapenem-resistant Kp (CR-Kp) pathogen represents a worldwide challenge due to its high mortality rates. It has become endemic in Italy, where there have been several reports of hospital outbreaks [1,2,3,4,5]. The increasing spread of nosocomial MDR Kp has led to the reintroduction of colistin, which is one of the few widely available therapeutic options for CR-Kp infections [7]. As a consequence of this renewed use, the isolation of colistin-resistant CR-Kp (CRCR-Kp) strains has gradually increased in
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
