Heteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains

Heteroresistance can lead to treatment failure and is difficult to detect by the methods currently employed by clinical laboratories. The aim of this study was to investigate the prevalence of the amikacin-heteroresistant Klebsiella pneumoniae strains and explore potential amikacin heteroresistance...

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Autores principales:	Feiyang Zhang, Qin Li, Jiawei Bai, Manlin Ding, Xiangjin Yan, Guangxi Wang, Baoli Zhu, Yingshun Zhou
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	Klebsiella pneumoniae amikacin heteroresistance carbapenem multidrug resistance Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/e8c8abe3a371456481bbb1426601a37d
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spelling	oai:doaj.org-article:e8c8abe3a371456481bbb1426601a37d2021-12-02T10:07:01ZHeteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains1664-302X10.3389/fmicb.2021.682239https://doaj.org/article/e8c8abe3a371456481bbb1426601a37d2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmicb.2021.682239/fullhttps://doaj.org/toc/1664-302XHeteroresistance can lead to treatment failure and is difficult to detect by the methods currently employed by clinical laboratories. The aim of this study was to investigate the prevalence of the amikacin-heteroresistant Klebsiella pneumoniae strains and explore potential amikacin heteroresistance mechanism through whole-genome sequencing (WGS) and quantitative reverse-transcription PCR (qRT-PCR). In this study, 13 isolates (8.39%) were considered as amikacin-heteroresistant K. pneumoniae strains among a total of 155 K. pneumoniae strains. The majority of the heterogeneous phenotypes (11/13, 84.61%) was unstable and the minimal inhibitory concentrations (MICs) fully or partially reverted back to the level of susceptibility of the parental isolate. The frequency of heteroresistant subpopulation ranged from 2.94×10−7 to 5.59×10−6. Whole-genome sequencing and single-nucleotide variants (SNVs) analysis showed that there were different nucleotide and resultant amino acid alterations among an amikacin-heteroresistant strain S38 and the resistant subpopulation S38L in several genes. Quantitative reverse-transcription PCR analysis revealed that the increased expression of aminoglycoside resistance genes detected in amikacin-heteroresistant K. pneumoniae strains might be associated with amikacin heteroresistance. The findings raise concerns for the emergence of amikacin-heteroresistant K. pneumoniae strains and the use of amikacin as therapy for the treatment of multidrug-resistant K. pneumoniae strains.Feiyang ZhangQin LiJiawei BaiManlin DingXiangjin YanGuangxi WangBaoli ZhuYingshun ZhouFrontiers Media S.A.articleKlebsiella pneumoniaeamikacinheteroresistancecarbapenemmultidrug resistanceMicrobiologyQR1-502ENFrontiers in Microbiology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Klebsiella pneumoniae amikacin heteroresistance carbapenem multidrug resistance Microbiology QR1-502
spellingShingle	Klebsiella pneumoniae amikacin heteroresistance carbapenem multidrug resistance Microbiology QR1-502 Feiyang Zhang Qin Li Jiawei Bai Manlin Ding Xiangjin Yan Guangxi Wang Baoli Zhu Yingshun Zhou Heteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains
description	Heteroresistance can lead to treatment failure and is difficult to detect by the methods currently employed by clinical laboratories. The aim of this study was to investigate the prevalence of the amikacin-heteroresistant Klebsiella pneumoniae strains and explore potential amikacin heteroresistance mechanism through whole-genome sequencing (WGS) and quantitative reverse-transcription PCR (qRT-PCR). In this study, 13 isolates (8.39%) were considered as amikacin-heteroresistant K. pneumoniae strains among a total of 155 K. pneumoniae strains. The majority of the heterogeneous phenotypes (11/13, 84.61%) was unstable and the minimal inhibitory concentrations (MICs) fully or partially reverted back to the level of susceptibility of the parental isolate. The frequency of heteroresistant subpopulation ranged from 2.94×10−7 to 5.59×10−6. Whole-genome sequencing and single-nucleotide variants (SNVs) analysis showed that there were different nucleotide and resultant amino acid alterations among an amikacin-heteroresistant strain S38 and the resistant subpopulation S38L in several genes. Quantitative reverse-transcription PCR analysis revealed that the increased expression of aminoglycoside resistance genes detected in amikacin-heteroresistant K. pneumoniae strains might be associated with amikacin heteroresistance. The findings raise concerns for the emergence of amikacin-heteroresistant K. pneumoniae strains and the use of amikacin as therapy for the treatment of multidrug-resistant K. pneumoniae strains.
format	article
author	Feiyang Zhang Qin Li Jiawei Bai Manlin Ding Xiangjin Yan Guangxi Wang Baoli Zhu Yingshun Zhou
author_facet	Feiyang Zhang Qin Li Jiawei Bai Manlin Ding Xiangjin Yan Guangxi Wang Baoli Zhu Yingshun Zhou
author_sort	Feiyang Zhang
title	Heteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains
title_short	Heteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains
title_full	Heteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains
title_fullStr	Heteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains
title_full_unstemmed	Heteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains
title_sort	heteroresistance to amikacin in carbapenem-resistant klebsiella pneumoniae strains
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/e8c8abe3a371456481bbb1426601a37d
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Heteroresistance to Amikacin in Carbapenem-Resistant Klebsiella pneumoniae Strains

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