Evolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland

ABSTRACT Klebsiella pneumoniae is a human commensal and opportunistic pathogen that has become a leading causative agent of hospital-based infections over the past few decades. The emergence and global expansion of hypervirulent and multidrug-resistant (MDR) clones of K. pneumoniae have been increas...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Danesh Moradigaravand, Veronique Martin, Sharon J. Peacock, Julian Parkhill
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2017
Materias:	Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/54597027bf1549b48a1c72fb2efdd27d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:54597027bf1549b48a1c72fb2efdd27d
record_format	dspace
spelling	oai:doaj.org-article:54597027bf1549b48a1c72fb2efdd27d2021-11-15T15:51:06ZEvolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland10.1128/mBio.01976-162150-7511https://doaj.org/article/54597027bf1549b48a1c72fb2efdd27d2017-03-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.01976-16https://doaj.org/toc/2150-7511ABSTRACT Klebsiella pneumoniae is a human commensal and opportunistic pathogen that has become a leading causative agent of hospital-based infections over the past few decades. The emergence and global expansion of hypervirulent and multidrug-resistant (MDR) clones of K. pneumoniae have been increasingly reported in community-acquired and nosocomial infections. Despite this, the population genomics and epidemiology of MDR K. pneumoniae at the national level are still poorly understood. To obtain insights into these, we analyzed a systematic large-scale collection of invasive MDR K. pneumoniae isolates from hospitals across the United Kingdom and Ireland. Using whole-genome phylogenetic analysis, we placed these in the context of previously sequenced K. pneumoniae populations from geographically diverse countries and identified their virulence and drug resistance determinants. Our results demonstrate that United Kingdom and Ireland MDR isolates are a highly diverse population drawn from across the global phylogenetic tree of K. pneumoniae and represent multiple recent international introductions that are mainly from Europe but in some cases from more distant countries. In addition, we identified novel genetic determinants underlying resistance to beta-lactams, gentamicin, ciprofloxacin, and tetracyclines, indicating that both increased virulence and resistance have emerged independently multiple times throughout the population. Our data show that MDR K. pneumoniae isolates in the United Kingdom and Ireland have multiple distinct origins and appear to be part of a globally circulating K. pneumoniae population. IMPORTANCE Klebsiella pneumoniae is a major human pathogen that has been implicated in infections in healthcare settings over the past few decades. Antimicrobial treatment of K. pneumoniae infections has become increasingly difficult as a consequence of the emergence and spread of strains that are resistant to multiple antimicrobials. To better understand the spread of resistant K. pneumoniae, we studied the genomes of a large-scale population of extensively antimicrobial-resistant K. pneumoniae in the United Kingdom and Ireland by utilizing the fine resolution that whole-genome sequencing of pathogen genomes provides. Our results indicate that the K. pneumoniae population is highly diverse and that, in some cases, resistant strains appear to have spread across the country over a few years. In addition, we found evidence that some strains have acquired antimicrobial resistance genes independently, presumably in response to antimicrobial treatment.Danesh MoradigaravandVeronique MartinSharon J. PeacockJulian ParkhillAmerican Society for MicrobiologyarticleMicrobiologyQR1-502ENmBio, Vol 8, Iss 1 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Microbiology QR1-502
spellingShingle	Microbiology QR1-502 Danesh Moradigaravand Veronique Martin Sharon J. Peacock Julian Parkhill Evolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland
description	ABSTRACT Klebsiella pneumoniae is a human commensal and opportunistic pathogen that has become a leading causative agent of hospital-based infections over the past few decades. The emergence and global expansion of hypervirulent and multidrug-resistant (MDR) clones of K. pneumoniae have been increasingly reported in community-acquired and nosocomial infections. Despite this, the population genomics and epidemiology of MDR K. pneumoniae at the national level are still poorly understood. To obtain insights into these, we analyzed a systematic large-scale collection of invasive MDR K. pneumoniae isolates from hospitals across the United Kingdom and Ireland. Using whole-genome phylogenetic analysis, we placed these in the context of previously sequenced K. pneumoniae populations from geographically diverse countries and identified their virulence and drug resistance determinants. Our results demonstrate that United Kingdom and Ireland MDR isolates are a highly diverse population drawn from across the global phylogenetic tree of K. pneumoniae and represent multiple recent international introductions that are mainly from Europe but in some cases from more distant countries. In addition, we identified novel genetic determinants underlying resistance to beta-lactams, gentamicin, ciprofloxacin, and tetracyclines, indicating that both increased virulence and resistance have emerged independently multiple times throughout the population. Our data show that MDR K. pneumoniae isolates in the United Kingdom and Ireland have multiple distinct origins and appear to be part of a globally circulating K. pneumoniae population. IMPORTANCE Klebsiella pneumoniae is a major human pathogen that has been implicated in infections in healthcare settings over the past few decades. Antimicrobial treatment of K. pneumoniae infections has become increasingly difficult as a consequence of the emergence and spread of strains that are resistant to multiple antimicrobials. To better understand the spread of resistant K. pneumoniae, we studied the genomes of a large-scale population of extensively antimicrobial-resistant K. pneumoniae in the United Kingdom and Ireland by utilizing the fine resolution that whole-genome sequencing of pathogen genomes provides. Our results indicate that the K. pneumoniae population is highly diverse and that, in some cases, resistant strains appear to have spread across the country over a few years. In addition, we found evidence that some strains have acquired antimicrobial resistance genes independently, presumably in response to antimicrobial treatment.
format	article
author	Danesh Moradigaravand Veronique Martin Sharon J. Peacock Julian Parkhill
author_facet	Danesh Moradigaravand Veronique Martin Sharon J. Peacock Julian Parkhill
author_sort	Danesh Moradigaravand
title	Evolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland
title_short	Evolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland
title_full	Evolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland
title_fullStr	Evolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland
title_full_unstemmed	Evolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland
title_sort	evolution and epidemiology of multidrug-resistant <italic toggle="yes">klebsiella pneumoniae</italic> in the united kingdom and ireland
publisher	American Society for Microbiology
publishDate	2017
url	https://doaj.org/article/54597027bf1549b48a1c72fb2efdd27d
work_keys_str_mv	AT daneshmoradigaravand evolutionandepidemiologyofmultidrugresistantitalictoggleyesklebsiellapneumoniaeitalicintheunitedkingdomandireland AT veroniquemartin evolutionandepidemiologyofmultidrugresistantitalictoggleyesklebsiellapneumoniaeitalicintheunitedkingdomandireland AT sharonjpeacock evolutionandepidemiologyofmultidrugresistantitalictoggleyesklebsiellapneumoniaeitalicintheunitedkingdomandireland AT julianparkhill evolutionandepidemiologyofmultidrugresistantitalictoggleyesklebsiellapneumoniaeitalicintheunitedkingdomandireland
_version_	1718427398202982400

Evolution and Epidemiology of Multidrug-Resistant <italic toggle="yes">Klebsiella pneumoniae</italic> in the United Kingdom and Ireland

Ejemplares similares