The issue of nosocomial infection caused by Klebsiella pneumoniae blaNDM-type

Authors

  • Olga Mironenko St. Petersburg North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federationrsity;St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation
  • Victoria Selnitseva St. Petersburg State City Hospital no. 2, 5, Uchebny per., St. Petersburg, 194354, Russian Federation
  • Lidia Soprun St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation
  • Elena Shmushkevich St. Petersburg State City Hospital no. 2, 5, Uchebny per., St. Petersburg, 194354, Russian Federation
  • Andrey Alekseev North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation
  • Aial Ivanov North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation
  • Anna Тоvanova North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation

DOI:

https://doi.org/10.21638/spbu11.2020.204

Abstract

The article presents information about circulating isolates Klebsiella pneumoniae in a hospital megapolis with properties of hypervirulence and simultaneous multiresistance. The resulting K. pneumonia isolates are of particular importance due to the emergence of resistance to almost all β-lactams due to the presence of carbapenemase metal-β-lactamase. Furthermore, the isolated strains producing carbapenemases possess mechanisms of resistance to a wide range of antimicrobial preparations, and the types of infectious process caused by carbapenemazo-producing enterobacteries are characterized by a high lethality level. Microbiological, biochemical, biophysical, molecular-genetic, biological, bioinformational and statistical methods of research were used in the work. A prospective method was used to identify the source of the infections. In the first stage, a microbiological study was carried out on biomaterials obtained from patients treated in a hospital in Saint Petersburg. After a microbiological study, 52 isolates of K. pneumoniae were obtained, 53.8 % of isolates had a hypermucoid phenotype and 98 % had carbapenemases:blaNDM type — 49 (92 %), blaNDM+OXA-48-like — 3 (8 %). Isolates with two new phenotypes have been isolated (no. 2511 and no. 2512). Isolates of no. 2512 LD50 had 10*2 BAC/ml, and plasmids such as Incfib(Mar), Inchi1b, and Incr were also found, with Incr-A plasmid emitted encoding resistance to fluoroquinolone: aac(6’)-Ib-cr and to β-lactam antibiotics: blaTEM-1B. The described data confirm the opinions of the researchers about the possible formation of a new “super pathogen” — instantaneously hypervirulent and plural resistant strain of K. pneumoniae.

Keywords:

K. pneumonia blaNDM, nosocomial infection, epidemiological process, carbapenemaza, hypervirulence

Downloads

Download data is not yet available.
 

References


References

Reshed’ko G. K., Rjabkova E. L., Krechikova O. I., Sukhorukova M. V., Shevchenko O. V., Edelstain M. V., Kozlov R. S., Turkutjukov V. B., Nekhaeva G. I., Bochkarev D. N., Rozanova S. M., Boronina L. G., Agapova E. D., Marusina N. E., Multikh I. G., Taraban V. K., Zdzitovetsky D. E., Sarmatova N. I., Tikhonov Yu. G., Polikarpova S. V., Bolschakov L. V., Bogomolova N. S., Dmitrieva N. V., Petuchova I. N., Galeeva E. V., Kruglov A. N., Vischelesskaya N. D., Aleksandrova I. A., Beloborodova N. V., Vostrikova T. Yu., Iljina V. N., Ivanova S. F., Skalsky S. V., Zubareva N. A., Suborova T. N.,Malischeva V. A., Osipova V. V., Shchetinin E. V., Nikolaeva T. A., Martianova N. M., Gudkova L. V., Ortenberg O. A., Uschakova M. A., Khasanova S. G., Gabbasova L. A., Kolesnik T. I., Toropova I. A., Paljutin Sch. H., Monachova S. I. Antimicrobial Resistance Patterns of Gramnegative Nosocomial Pathogens in Russian ICUs. Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia, 2008, vol. 10,no. 2, pp. 96–112. (In Russian)

European Committee on Antimicrobial Susceptibility Testing. EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance, version 1.0, 2012. Available at: https://www.eucast.org/resistance_mechanisms (accessed: 27.09.2020).

Santajit S., Indrawattana N. Mechanisms of Antimicrobial Resistance in ESKAPE Pathogens. BioMed Res. Int., 2016, vol. 2016, Article ID 2475067. https://doi.org/10.1155/2016/2475067.

Rosenthal V. D., Al-Abdely H. M., El-Kholy A. A., et al. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010–2015: Device-associated module. Am. J. Infect. Control, 2016, vol. 44, no. 12, pp. 1495–1504.

Pan Z., Liu R., Zhang P., Zhou H., Fu Y., Zhou J. Combination of tigecycline and levofloxacin for successful treatment of nosocomial pneumonia caused by New Delhi Metallo-β-Lactamase-1-producing Raoultella planticola.Microb. Drug Resist., 2016, vol. 23, no. 1, pp. 127–131.

Sidjabat H. E., Townell N., Nimmo G. R., George N. M., Robson J., Vohra R., Davis L., Heney C., Paterson D. L. Dominance of IMP-4-producing Enterobacter cloacae among carbapenemase-producing Enterobacteriaceae in Australia. Antimicrob. Agents Chemother., 2015, vol. 59, no. 7, pp. 4059–4066. https://doi.org/10.1128/AAC. 04378-14.

Ahmad N., Ali S. M., Khan A. U. First reported New Delhi metallo-β-lactamase-1- producing Cedecea lapagei. In.t J. Antimicrob. Agents, 2017, vol. 49, no. 1, pp. 118–119. https://doi.org/10.1016/j.ijantimicag.2016.10.001.

Wang Q., Zhang Y., Yao X., Xian H., Liu Y., Li H., Chen H., Wang X., Wang R., Zhao C., Cao B.,Wang H. Risk factors and clinical outcomes for carbapenem-resistant Enterobacteriaceae nosocomial infections. Eur. J. Clin. Microbio.l Infect. Dis., 2016, vol. 35, pp. 1679–1689. https://doi.org/10.1007/s10096-016–2710-0.

Quan J., Li X., Chen Y., Jiang Y., Zhou Z., Zhang H., Sun L., Ruan Z., Feng Y., Akova M., Yu Y. Prevalence of mcr-1 in Escherichia coli and Klebsiella pneumoniae recovered from bloodstream infections in China: a multicentre longitudinal study. Lancet Infect. Dis., 2017, vol.17, no. 4, pp. 400–410. https://doi.org/10.1016/S1473-3099(16)30528-X.

Xie L., Dou Y., Zhou K., Chen Y., Han L., Guo X., Sun J. Coexistence of blaOXA48 and truncated blaNDM-1 on different plasmids in a Klebsiella pneumoniae isolate in China. Front. Microbiol., 2017, vol. 8, p. 133.https://doi.org/10.3389/fmicb.2017.00133.

Joshi P. R., Acharya M., Kakshapati T., Leungtongkam U., Thummeepak R., Sitthisak S. Co-existence of blaOXA–23 and blaNDM-1 genes of Acinetobacter baumannii isolated from Nepal: antimicrobial resistance and clinical significance. Antimicrob. Resist. Infect. Control, 2017, vol. 6, pp. 1–7. https://doi.org/10.1186/s13756-017-0180-5.

Göttig S., Hamprecht A. G., Christ S., Kempf V. A., Wichelhaus T. A. Detection of NDM-7 in Germany, a new variant of the New Delhi metallo- β -lactamase with increased carbapenemase activity. J. Antimicrob. Chemother., 2013, vol. 68, no. 8, pp. 1737–1740. https://doi.org/10.1093/jac/dkt088.

Dortet L., Poirel L., Nordmann P. Worldwide dissemination of the NDM-type carbapenemases in Gram-negative bacteria. BioMed Res. Int., 2014, vol. 2014, Article ID 249856. https://doi.org/10.1155/2014/249856.

Gupta N., Limbago B. M., Patel J. B., Kallen A. J. Carbapenem-resistant Enterobacteriaceae: epidemiology and prevention. Clin. Infect. Dis., 2011, vol. 53, no. 1, pp. 60–67. https://doi.org/10.1093/cid/cir202.

Isozumi R., Yoshimatsu K., Yamashiro T., Hasebe F., Nguyen B. M., Ngo T. C., Yasuda S. P., Koma T., Shimizu K., Arikawa J. blaNDM-1-positive Klebsiella pneumoniae from environment, Vietnam. Emerg. Infect. Dis., 2012, vol. 18, no. 8, pp. 1383–1385. https://doi.org/10.3201/eid1808.

Kim S. Y., Rhee J. Y., Shin S. Y., Ko K. S. Characteristics of communityonset NDM-1-producing Klebsiella pneumonia isolates. J. Med. Microbiol., 2014, vol. 63, no. 1, pp. 86–89. https://doi.org/10.1099/jmm.0.067744-0.

Wailan A. M., Paterson D. L. The spread and acquisition of NDM-1: a multifactorial problem. Expert Rev. Anti. Infect. Ther., 2014, vol. 12, no. 1, pp. 91–115. https://doi.org/10.1586/14787210.2014.856756.

Shabanova V. V., Krasnova M. V., Bozhkova S. A., Ageevets V. A., Lazareva I. V., Rukina A. N., Sidorenko S. V. The first case of revealing of Klebsiella pneumoniae ST147, producing NDM-1 carbapenemase, in trauma and orthopedic hospital in Russia. Traumatology and Orthopedics of Russia, 2015, vol. 2,no. 76, pp. 90–98. (In Russian)

Suhorukova M. V., Jejdel’shtejn M. V., Skleenova E. J., Ivanchik N. V., Timokhova A. V., Dekhnich A. V., Kozlov R. S., Popov D. A. Antimicrobial resistance of nosocomial Enterobacteriaceae isolated in Russia: results of the national multicenter surveillance study “MARATHON” 2011–2012. Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia, 2014, vol. 16, no. 4, pp. 254–265. (In Russian)

Sidorenko S. V., Tishkov V. I. Molecular basis of resistance. Uspekhi biologicheskoi khimii, 2004, vol. 44,pp. 263–306. (In Russian)

Lev A. I., Astashkin E. I., Shaikhutdinova R. Z., Platonov M. E., Kartsev N. N., Volozhantsev N. V., Ershova O. N., Svetoch E. A., Fursova N. K. Identification of IS1R and IS10R elements inserted into ompk36 porin gene of two multidrug-resistant Klebsiella Pneumonia ehospital strains. FEMS Microbiol. Lett., 2017, vol. 364, no. 10, p. 364. https://doi.org/10.1093/femsle/fnx072.

Astashkin E. I., Lev A. I., Karcev N. N., Ershova O. N., Aleksandrova I. A., Svetoch E. A., Fursova N. K. Detection of the CTX-M-15 cephalosporinase gene and an atypical class 1 integron in a clinical isolate of Pseudomonas aeruginosa. Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia, 2016, vol. 18, no. 2, sup. 1, pp. 13–14. (In Russian)

Downloads

Published

2020-11-02

How to Cite

Mironenko , O., Selnitseva, V., Soprun, L. ., Shmushkevich, E., Alekseev , A. ., Ivanov , A., & Тоvanova A. . (2020). The issue of nosocomial infection caused by Klebsiella pneumoniae blaNDM-type. Vestnik of Saint Petersburg University. Medicine, 15(2), 124–133. https://doi.org/10.21638/spbu11.2020.204

Issue

Section

Epidemiology

Most read articles by the same author(s)