Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China

Objectives Hypervirulent Klebsiella pneumoniae(hvKp) is an increasingly important pathogen. Tracking its epidemiology and evolving antimicrobial resistance will facilitate care. Methods A retrospective study was conducted in two hospitals. We collected the clinical data. Antimicrobial and virulence-...

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Autores principales:	Chao Liu, Pengcheng Du, Nan Xiao, Fansen Ji, Thomas A. Russo, Jun Guo
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2020
Materias:	hypervirulent klebsiella pneumoniae multi drug resistance carbapenemase epidemiology nosocomial infection clinical characteristics risk factor Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/761b319862c34c34ac1202d0d62d6109
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spelling	oai:doaj.org-article:761b319862c34c34ac1202d0d62d61092021-11-17T14:21:58ZHypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China2150-55942150-560810.1080/21505594.2020.1809322https://doaj.org/article/761b319862c34c34ac1202d0d62d61092020-12-01T00:00:00Zhttp://dx.doi.org/10.1080/21505594.2020.1809322https://doaj.org/toc/2150-5594https://doaj.org/toc/2150-5608Objectives Hypervirulent Klebsiella pneumoniae(hvKp) is an increasingly important pathogen. Tracking its epidemiology and evolving antimicrobial resistance will facilitate care. Methods A retrospective study was conducted in two hospitals. We collected the clinical data. Antimicrobial and virulence-associated phenotype and genotype, sequence type, and whole genome sequencing of selected strains were performed. HvKp was defined by the presence of some combination of prmpA, prmpA2, iucA, iroB, and peg-344, genes shown to accurately identify hvKp. Results Of 158 Kp clinical isolates, 79 (50%) were hvKp. Interestingly, 53/79 (67.1%) of hvKp strains were isolated from patients with nosocomial infection and 19/79 (24.1%) from patients with healthcare-associated infection, but only 7/79 (8.8%) from patients with community-acquired infections. Importantly, 27/53 (50.9%) and 4/19 (21.1%) of hvKp nosocomial and healthcare-associated isolates, respectively, were multi-drug-resistant (MDR); 25/53 (47.2%) and 5/19 (26.3%) expressed ESBLs and 14/53 (26.4%) and 2/19 (10.5%) were carbapenem-resistant. Of the hvKp isolates from community-acquired infection, 0/7 (0%) were MDR and 0/7 (0%) were carbapenem-resistant. Additionally, unique characteristics of nosocomial, healthcare-associated, and community-acquired hvKp infection were identified. In summary, 50% of K. pneumoniae infections were caused by hvKp. A concerning, novel finding from this report is a major shift in hvKp epidemiology. Ninety-one percent of hvKp infections were nosocomial or healthcare-associated, and 43.1% of these isolates were MDR. Conclusions These data suggest that hvKp may be replacing classical K. pneumoniae as the dominant nosocomial and healthcare-associated pathotype. Ongoing surveillance is needed to determine if this trend is occurring elsewhere.Chao LiuPengcheng DuNan XiaoFansen JiThomas A. RussoJun GuoTaylor & Francis Grouparticlehypervirulent klebsiella pneumoniaemulti drug resistancecarbapenemaseepidemiologynosocomial infectionclinical characteristicsrisk factorInfectious and parasitic diseasesRC109-216ENVirulence, Vol 11, Iss 1, Pp 1215-1224 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	hypervirulent klebsiella pneumoniae multi drug resistance carbapenemase epidemiology nosocomial infection clinical characteristics risk factor Infectious and parasitic diseases RC109-216
spellingShingle	hypervirulent klebsiella pneumoniae multi drug resistance carbapenemase epidemiology nosocomial infection clinical characteristics risk factor Infectious and parasitic diseases RC109-216 Chao Liu Pengcheng Du Nan Xiao Fansen Ji Thomas A. Russo Jun Guo Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China
description	Objectives Hypervirulent Klebsiella pneumoniae(hvKp) is an increasingly important pathogen. Tracking its epidemiology and evolving antimicrobial resistance will facilitate care. Methods A retrospective study was conducted in two hospitals. We collected the clinical data. Antimicrobial and virulence-associated phenotype and genotype, sequence type, and whole genome sequencing of selected strains were performed. HvKp was defined by the presence of some combination of prmpA, prmpA2, iucA, iroB, and peg-344, genes shown to accurately identify hvKp. Results Of 158 Kp clinical isolates, 79 (50%) were hvKp. Interestingly, 53/79 (67.1%) of hvKp strains were isolated from patients with nosocomial infection and 19/79 (24.1%) from patients with healthcare-associated infection, but only 7/79 (8.8%) from patients with community-acquired infections. Importantly, 27/53 (50.9%) and 4/19 (21.1%) of hvKp nosocomial and healthcare-associated isolates, respectively, were multi-drug-resistant (MDR); 25/53 (47.2%) and 5/19 (26.3%) expressed ESBLs and 14/53 (26.4%) and 2/19 (10.5%) were carbapenem-resistant. Of the hvKp isolates from community-acquired infection, 0/7 (0%) were MDR and 0/7 (0%) were carbapenem-resistant. Additionally, unique characteristics of nosocomial, healthcare-associated, and community-acquired hvKp infection were identified. In summary, 50% of K. pneumoniae infections were caused by hvKp. A concerning, novel finding from this report is a major shift in hvKp epidemiology. Ninety-one percent of hvKp infections were nosocomial or healthcare-associated, and 43.1% of these isolates were MDR. Conclusions These data suggest that hvKp may be replacing classical K. pneumoniae as the dominant nosocomial and healthcare-associated pathotype. Ongoing surveillance is needed to determine if this trend is occurring elsewhere.
format	article
author	Chao Liu Pengcheng Du Nan Xiao Fansen Ji Thomas A. Russo Jun Guo
author_facet	Chao Liu Pengcheng Du Nan Xiao Fansen Ji Thomas A. Russo Jun Guo
author_sort	Chao Liu
title	Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China
title_short	Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China
title_full	Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China
title_fullStr	Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China
title_full_unstemmed	Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China
title_sort	hypervirulent klebsiella pneumoniae is emerging as an increasingly prevalent k. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in beijing, china
publisher	Taylor & Francis Group
publishDate	2020
url	https://doaj.org/article/761b319862c34c34ac1202d0d62d6109
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Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China

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