Abstract
Klebsiella pneumoniae is a common pathogen associated with nosocomial infections and is characterised serologically by capsular polysaccharide (K) and lipopolysaccharide O antigens. We surveyed a total of 348 non-duplicate K. pneumoniae clinical isolates collected over a 1-year period in a tertiary care hospital, and determined their O and K serotypes by sequencing of the wbb Y and wzi gene loci, respectively. Isolates were also screened for antimicrobial resistance and hypervirulent phenotypes; 94 (27.0%) were identified as carbapenem-resistant (CRKP) and 110 (31.6%) as hypervirulent (hvKP). isolates fell into 58 K, and six O types, with 92.0% and 94.2% typeability, respectively. The predominant K types were K14K64 (16.38%), K1 (14.66%), K2 (8.05%) and K57 (5.46%), while O1 (46%), O2a (27.9%) and O3 (11.8%) were the most common. CRKP and hvKP strains had different serotype distributions with O2a:K14K64 (41.0%) being the most frequent among CRKP, and O1:K1 (26.4%) and O1:K2 (17.3%) among hvKP strains. Serotyping by gene sequencing proved to be a useful tool to inform the clinical epidemiology of K. pneumoniae infections and provides valuable data relevant to vaccine design.
Highlights
Several methods have been used for the type identification of K. pneumoniae isolates including capsular polysaccharide (K) and lipopolysaccharide (O) antigen characterisation, DNA restriction analysis by pulsed-field gel electrophoresis and multilocus sequence typing, among others [3]
As access to O and K typing antisera is no longer a viable option, and knowledge of serotype distributions among K. pneumoniae isolates in mainland China is limited, we undertook a prevalence study of clinical isolates from our tertiary hospital centre in Shanghai using gene sequencing of O and K serotype-specific chromosomal regions to determine the distribution of strain serotypes
Bacterial identification and antimicrobial susceptibility testing were performed by the Vitek2 system (Biomérieux, France) and susceptibility results were reported according to Clinical and Laboratory Standards Institute (CLSI) guidelines
Summary
Several methods have been used for the type identification of K. pneumoniae isolates including capsular polysaccharide (K) and lipopolysaccharide (O) antigen characterisation, DNA restriction analysis by pulsed-field gel electrophoresis and multilocus sequence typing, among others [3]. A CRKP strain was defined as an isolate resistant to at least one carbapenem antibiotic. Twenty-nine CRKP-infected patients had received carbapenem antibiotics in the 3 months prior to recovery of the isolate.
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