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Enferm Infecc Microbiol Clin. 2018 Dec 12. pii: S0213-005X(18)30369-0. doi: 10.1016/j.eimc.2018.11.001. [Epub ahead of print]

Virulence and resistance determinants of Klebsiella pneumoniae isolated from a Portuguese tertiary university hospital centre over a 31-year period.

[Article in English, Spanish]

Author information

1
Microbiology and Immunology Department, Interdisciplinary Research Centre Egas Moniz (CiiEM), Faculty of Pharmacy, University of Lisbon, 1649-003, Lisbon, Portugal; Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon, 1649-028, Lisbon, Portugal. Electronic address: ccaneiras@gmail.com.
2
Laboratory of Microbiology, Centro Hospitalar Lisboa Norte, 1649-035, Lisbon, Portugal.
3
Pneumological Department, Moncloa University Hospital, 28008, Madrid, Spain; European University, 28108, Alcobendas, Madrid, Spain.
4
Pneumological Department, Ramón y Cajal University Hospital, Madrid, Spain; Institute Ramón y Cajal for Health Research (IRYCIS), Alcalá de Henares University, 28034, Madrid, Spain.
5
Laboratory of Microbiology, Centro Hospitalar Lisboa Norte, 1649-035, Lisbon, Portugal; Institute of Microbiology, Faculty of Medicine, University of Lisbon, 1649-028, Lisbon, Portugal; Institute of Microbiology, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
6
Microbiology and Immunology Department, Interdisciplinary Research Centre Egas Moniz (CiiEM), Faculty of Pharmacy, University of Lisbon, 1649-003, Lisbon, Portugal.

Abstract

INTRODUCTION:

The rapid and complex evolution of bacterial resistance mechanisms in Klebsiella pneumoniae producing extended-spectrum β-lactamases and carbapenemases in Klebsiella pneumoniae is one of the most significant threats to public health. However, questions and controversies regarding the interactions between resistance and virulence in multidrug-resistant K. pneumoniae isolates remain unclear.

METHODS:

A retrospective cohort study was performed with 100 K. pneumoniae isolates recovered from a tertiary care university hospital centre in Lisbon over a 31-year period. Resistance and virulence determinants were screened using molecular methods (PCR, M13-PCR and MLST).

RESULTS:

The predominant virulence profile (fimH, mrkDv1, khe) was shared by all isolates, indicative of an important role of type 1 and 3 fimbrial adhesins and haemolysin, regardless of the type of β-lactamase produced. However, accumulation of virulence factors was identified in KPC-3-producers, with a higher frequency (p<0.05) of capsular serotype K2 and iucC aerobactin when compared with non-KPC-3 β-lactamases or carbapenemases. Additionally, 9 different virulence profiles were found, indicating that the KPC-3 carbapenemase producers seem to adapt successfully to the host environment and maintain virulence via several pathways.

CONCLUSION:

This study describes an overlapping of multidrug-resistance and virulence determinants in ST-14K2 KPC-3 K. pneumoniae clinical isolates that may impose an additional challenge in the treatment of infections caused by this pathogen.

KEYWORDS:

Bacterial infections; Beta-lactamasas; Beta-lactamases; Cross-infection; Infecciones bacterianas; Infección cruzada; Klebsiella pneumoniae; Virulence; Virulencia

PMID:
30553621
DOI:
10.1016/j.eimc.2018.11.001

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