Resistance mechanisms and population structure of highly drug resistant Klebsiella in Pakistan during the introduction of the carbapenemase NDM-1.

Scientific Reports
Eva HeinzRichard A Strugnell

Abstract

Klebsiella pneumoniae is a major threat to public health with the emergence of isolates resistant to most, if not all, useful antibiotics. We present an in-depth analysis of 178 extended-spectrum beta-lactamase (ESBL)-producing K. pneumoniae collected from patients resident in a region of Pakistan, during the period 2010-2012, when the now globally-distributed carbapenemase bla-NDM-1 was being acquired by Klebsiella. We observed two dominant lineages, but neither the overall resistance profile nor virulence-associated factors, explain their evolutionary success. Phenotypic analysis of resistance shows few differences between the acquisition of resistance genes and the phenotypic resistance profile, including beta-lactam antibiotics that were used to treat ESBL-positive strains. Resistance against these drugs could be explained by inhibitor-resistant beta-lactamase enzymes, carbapenemases or ampC type beta-lactamases, at least one of which was detected in most, but not all relevant strains analysed. Complete genomes for six selected strains are reported, these provide detailed insights into the mobile elements present in these isolates during the initial spread of NDM-1. The unexplained success of some lineages within this pool ...Continue Reading

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Citations

Jul 22, 2020·Antimicrobial Agents and Chemotherapy·Sara E BoydWilliam W Hope
Feb 15, 2020·Nature Reviews. Microbiology·Kelly L WyresKathryn E Holt
Dec 5, 2020·Microbial Drug Resistance : MDR : Mechanisms, Epidemiology, and Disease·Virginia Garcia-FulgueirasCarolina Márquez
Jul 24, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Francisco Javier CandelAntonio Oliver

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Datasets Mentioned

BETA
CP008929

Methods Mentioned

BETA
ICE

Software Mentioned

BLASTp
mafft
RAxML 86
canu
samtools mpileup
smrt
ARG
bedtools
MLST
ANNOT

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