Abstract
Since the spread of multidrug-resistant Klebsiella pneumoniae (MDRKP) strains is considered as a challenge for patients with weakened or suppressed immunity, the emergence of isolates carrying determinants of hypervirulent phenotypes in addition may become a serious problem even for healthy individuals. The aim of this study is an investigation of the nonoutbreak K. pneumoniae emergence occurred in early 2017 at a maternity hospital of Kazan, Russia. Ten bacterial isolates demonstrating multiple drug resistance phenotypes were collected from eight healthy full-term breastfed neonates, observed at the maternity hospital of Kazan, Russia. All the infants and their mothers were dismissed without symptoms or complaints, in a satisfactory condition. Whole-genome shotgun (WGS) sequencing was performed with the purpose to track down a possible spread source(s) and obtain detailed information about resistance determinants and pathogenic potential of the collected isolates. Microdilution tests have confirmed production of extended-spectrum β-lactamases (ESBL) and their resistance to aminoglycoside, β-lactam, fluoroquinolone, sulfonamide, nitrofurantoin, trimethoprim, and fosfomycin antibiotics and Klebsiella phage. The WGS analysis has revealed the genes that are resistant to aminoglycosides, fluoroquinolones, macrolides, sulfonamides, chloramphenicols, tetracyclines, and trimethoprim and ESBL determinants. The pangenome analysis had split the isolates into two phylogenetic clades. The first group, a more heterogeneous clade, was represented by 5 isolates with 4 different in silico multilocus sequence types (MLSTs). The second group contained 5 isolates from infants born vaginally with the single MLST ST23, positive for genes corresponding to hypervirulent phenotypes: yersiniabactin, aerobactin, salmochelin, colibactin, hypermucoid determinants, and specific alleles of K- and O-antigens. The source of the MDRKP spread was not defined. Infected infants have shown no developed disease symptoms.
Highlights
Newborn babies could obtain microorganisms from clinical environment, personnel, other patients, and parents, e.g., via breast milk
Klebsiella pneumoniae is a causative agent of numerous nosocomial and community acquired infections including pneumonia, sepsis, bacteremia, meningitis, pyogenic liver abscesses, urinary tract infections, and more. e risk group
A total of 10 K. pneumoniae isolates demonstrating a multidrug resistance phenotype were collected from 10 stool samples (8 nonrepetitive) from 8 newborn fullterm breastfed infants during hospitalization in a maternity hospital of Kazan, Russia. 5 neonates were born with vaginal delivery, 3 after cesarean surgery
Summary
Newborn babies could obtain microorganisms from clinical environment, personnel, other patients, and parents, e.g., via breast milk. Due to high horizontal gene transport frequency between the microbiome members, persistence of even a single strain carrying pathobiotic genes after its spread may cause explicit cytotoxic and genotoxic effects on host cells, leading to dangerous repercussion including colorectal cancer in particular [1]. International Journal of Microbiology historically includes patients with a weakened and malfunctioning immune system, but the spread of hypervirulent strains endangers immunosufficient individuals [3]. First isolated from the lungs of patients with pneumonia postmortem, K. pneumoniae were acknowledged as a part of the normal human gastrointestinal tract microbiome since . E colonization can spread, persist for years, and cause different pathologies from hidden carriage to fatal acute infections even for healthy individuals [4]. We applied whole-genome shotgun (WGS) sequencing to describe in detail 8 cases of asymptomatic carriage of multidrug-resistant K. pneumoniae (MDRKP) in the gastrointestinal tract of full-term infants, detected at similar time periods after the birth without visible symptoms in their health
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 call
