Plasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy

ABSTRACT Antibiotics, which are used both to prevent and to treat infections, are a mainstay therapy for lifesaving procedures such as transplantation. For this reason, and many others, increased antibiotic resistance among human-associated pathogens, such as the carbapenem-resistant Enterobacteriac...

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Autores principales:	Sean Conlan, Anna F. Lau, Clay Deming, Christine D. Spalding, ShihQueen Lee-Lin, Pamela J. Thomas, Morgan Park, John P. Dekker, Karen M. Frank, Tara N. Palmore, Julia A. Segre
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2019
Materias:	Enterobacteriaceae HGT Klebsiella antibiotic resistance carbapenems genomes Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/43d2293eef194b7a9a9cfe66420d1727
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spelling	oai:doaj.org-article:43d2293eef194b7a9a9cfe66420d17272021-11-15T15:59:41ZPlasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy10.1128/mBio.00652-192150-7511https://doaj.org/article/43d2293eef194b7a9a9cfe66420d17272019-10-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.00652-19https://doaj.org/toc/2150-7511ABSTRACT Antibiotics, which are used both to prevent and to treat infections, are a mainstay therapy for lifesaving procedures such as transplantation. For this reason, and many others, increased antibiotic resistance among human-associated pathogens, such as the carbapenem-resistant Enterobacteriaceae species, is of grave concern. In this study, we report on a hematopoietic stem cell transplant recipient in whom cultures detected the emergence of carbapenem resistance and spread across five strains of bacteria that persisted for over a year. Carbapenem resistance in Citrobacter freundii, Enterobacter cloacae, Klebsiella aerogenes, and Klebsiella pneumoniae was linked to a pair of plasmids, each carrying the Klebsiella pneumoniae carbapenemase gene (blaKPC). Surveillance cultures identified a carbapenem-susceptible strain of Citrobacter freundii that may have become resistant through horizontal gene transfer of these plasmids. Selection of a multidrug-resistant Klebsiella pneumoniae strain was also detected following combination antibiotic therapy. Here we report a plasmid carrying the blaKPC gene with broad host range that poses the additional threat of spreading to endogenous members of the human gut microbiome. IMPORTANCE Antibiotic-resistant bacteria are a serious threat to medically fragile patient populations. The spread of antibiotic resistance through plasmid-mediated mechanisms is of grave concern as it can lead to the conversion of endogenous patient-associated strains to difficult-to-treat pathogens.Sean ConlanAnna F. LauClay DemingChristine D. SpaldingShihQueen Lee-LinPamela J. ThomasMorgan ParkJohn P. DekkerKaren M. FrankTara N. PalmoreJulia A. SegreAmerican Society for MicrobiologyarticleEnterobacteriaceaeHGTKlebsiellaantibiotic resistancecarbapenemsgenomesMicrobiologyQR1-502ENmBio, Vol 10, Iss 5 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Enterobacteriaceae HGT Klebsiella antibiotic resistance carbapenems genomes Microbiology QR1-502
spellingShingle	Enterobacteriaceae HGT Klebsiella antibiotic resistance carbapenems genomes Microbiology QR1-502 Sean Conlan Anna F. Lau Clay Deming Christine D. Spalding ShihQueen Lee-Lin Pamela J. Thomas Morgan Park John P. Dekker Karen M. Frank Tara N. Palmore Julia A. Segre Plasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy
description	ABSTRACT Antibiotics, which are used both to prevent and to treat infections, are a mainstay therapy for lifesaving procedures such as transplantation. For this reason, and many others, increased antibiotic resistance among human-associated pathogens, such as the carbapenem-resistant Enterobacteriaceae species, is of grave concern. In this study, we report on a hematopoietic stem cell transplant recipient in whom cultures detected the emergence of carbapenem resistance and spread across five strains of bacteria that persisted for over a year. Carbapenem resistance in Citrobacter freundii, Enterobacter cloacae, Klebsiella aerogenes, and Klebsiella pneumoniae was linked to a pair of plasmids, each carrying the Klebsiella pneumoniae carbapenemase gene (blaKPC). Surveillance cultures identified a carbapenem-susceptible strain of Citrobacter freundii that may have become resistant through horizontal gene transfer of these plasmids. Selection of a multidrug-resistant Klebsiella pneumoniae strain was also detected following combination antibiotic therapy. Here we report a plasmid carrying the blaKPC gene with broad host range that poses the additional threat of spreading to endogenous members of the human gut microbiome. IMPORTANCE Antibiotic-resistant bacteria are a serious threat to medically fragile patient populations. The spread of antibiotic resistance through plasmid-mediated mechanisms is of grave concern as it can lead to the conversion of endogenous patient-associated strains to difficult-to-treat pathogens.
format	article
author	Sean Conlan Anna F. Lau Clay Deming Christine D. Spalding ShihQueen Lee-Lin Pamela J. Thomas Morgan Park John P. Dekker Karen M. Frank Tara N. Palmore Julia A. Segre
author_facet	Sean Conlan Anna F. Lau Clay Deming Christine D. Spalding ShihQueen Lee-Lin Pamela J. Thomas Morgan Park John P. Dekker Karen M. Frank Tara N. Palmore Julia A. Segre
author_sort	Sean Conlan
title	Plasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy
title_short	Plasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy
title_full	Plasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy
title_fullStr	Plasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy
title_full_unstemmed	Plasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy
title_sort	plasmid dissemination and selection of a multidrug-resistant <named-content content-type="genus-species">klebsiella pneumoniae</named-content> strain during transplant-associated antibiotic therapy
publisher	American Society for Microbiology
publishDate	2019
url	https://doaj.org/article/43d2293eef194b7a9a9cfe66420d1727
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Plasmid Dissemination and Selection of a Multidrug-Resistant <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Strain during Transplant-Associated Antibiotic Therapy

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