Abstract
Carbapenem resistance among Klebsiella pneumoniae isolates is often related to carbapenemase genes, located in genetic transmissible elements, particularly the blaKPC gene, which variants are spread in several countries. Recently, reports of K. pneumoniae isolates harboring the blaNDM gene have increased dramatically along with the dissemination of epidemic high-risk clones (HRCs). In the present study, we report the multiclonal spread of New Delhi metallo-beta-lactamase (NDM)-producing K. pneumoniae in different healthcare institutions in the state of Pará, Northern Brazil. A total of 23 NDM-producing isolates were tested regarding antimicrobial susceptibility testing features, screening of carbapenemase genes, and genotyping by multilocus sequencing typing (MLST). All K. pneumoniae isolates were determined as multidrug-resistant (MDR), being mainly resistant to carbapenems, cephalosporins, and fluoroquinolones. The blaNDM-7 (60.9%—14/23) and blaNDM-1 (34.8%—8/23) variants were detected. MLST genotyping revealed the predomination of HRCs, including ST11/CC258, ST340/CC258, ST15/CC15, ST392/CC147, among others. To conclude, the present study reveals the contribution of HRCs and non-HRCs in the spread of NDM-1 and NDM-7-producing K. pneumoniae isolates in Northern (Amazon region) Brazil, along with the first detection of NDM-7 variant in Latin America and Brazil, highlighting the need for surveillance and control of strains that may negatively impact healthcare and antimicrobial resistance.
Highlights
Klebsiella pneumoniae is among the major pathogens causing healthcare-related infections (HAIs) and outbreaks in several healthcare institutions
Carbapenem-resistant K. pneumoniae isolates (CR-Kp) are usually detected harboring the blaKPC gene, with endemicity reported in Brazil and several other countries, while the dissemination of New Delhi metallo-beta-lactamase (NDM)-producing K. pneumoniae has increased in several regions, and mainly during the COVID-19 pandemic [3,4,5,6,7,8]
This study describes the alarming dissemination of NDM -1 and NDM-7 in association with K. pneumoniae high-risk clones (HRCs) in different healthcare institutions in northern Brazil, being the first detection of NDM-7 circulating in Latin America and Brazil
Summary
Klebsiella pneumoniae is among the major pathogens causing healthcare-related infections (HAIs) and outbreaks in several healthcare institutions. Carbapenem-resistant K. pneumoniae isolates (CR-Kp) are usually detected harboring the blaKPC gene, with endemicity reported in Brazil and several other countries, while the dissemination of NDM-producing K. pneumoniae has increased in several regions, and mainly during the COVID-19 pandemic [3,4,5,6,7,8]. Such highly resistant-strains carrying resistance mechanisms are associated with so-called high-risk clones (HRCs), to strains belonging to the clonal complex 258 (CC258).
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