Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Outbreak of Colistin and Carbapenem-Resistant Klebsiella Pneumoniae St16 Co-Producing Ndm-1 and Oxa-48 Isolates in an Iranian Hospital Publisher Pubmed



Sanikhani R1 ; Akbari M2 ; Hosseinzadeh M3 ; Siavash M2 ; Badmasti F1 ; Solgi H2, 4
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
  2. 2. Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Genetics and Molecular Biology, School of Medicine Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Laboratory Medicine, Amin Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Source: BMC Microbiology Published:2024


Abstract

Background: Colistin and carbapenem-resistant Klebsiella pneumoniae (Col-CRKP) represent a significant and constantly growing threat to global public health. We report here an outbreak of Col-CRKP infections during the fifth wave of COVID-19 pandemic. Methods: The outbreak occurred in an intensive care unit with 22 beds at a teaching university hospital, Isfahan, Iran. We collected eight Col-CRKP strains from seven patients and characterized these strains for their antimicrobial susceptibility, determination of hypermucoviscous phenotype, capsular serotyping, molecular detection of virulence and resistance genes. Clonal relatedness of the isolates was performed using MLST. Results: The COVID-19 patients were aged 24–75 years with at least 50% pulmonary involvement and were admitted to the intensive care unit. They all had superinfection caused by Col-CRKP, and poor responses to antibiotic treatment and died. With the exception of one isolate that belonged to the ST11, all seven representative Col-CRKP strains belonged to the ST16. Of these eight isolates, one ST16 isolate carried the iucA and ybtS genes was identified as serotype K20 hypervirulent Col-CRKP. The blaSHV and blaNDM-1 genes were the most prevalent resistance genes, followed by blaOXA-48 and blaCTX-M-15 and blaTEM genes. Mobilized colistin-resistance genes were not detected in the isolates. Conclusions: The continual emergence of ST16 Col-CRKP strains is a major threat to public health worldwide due to multidrug-resistant and highly transmissible characteristics. It seems that the potential dissemination of these clones highlights the importance of appropriate monitoring and strict infection control measures to prevent the spread of resistant bacteria in hospitals. © The Author(s) 2024.
Related Docs
View other Related Docs
1. Molecular Characterization of Ndm and Oxa-48-Like-Producing Klebsiella Pneumoniae St16 and Hypervirulent St337 Clone Among Two Patients; a Case Report, BMC Infectious Diseases (2024)
2. Association of Fluoroquinolone Resistance and Esbl Production in Hypervirulent Klebsiella Pneumoniae St11 and St893 in Iran, Acta Microbiologica et Immunologica Hungarica (2022)
3. Isolation, Characterization, Therapeutic Potency, and Genomic Analysis of a Novel Bacteriophage Vb_Kshkpc-M Against Carbapenemase-Producing Klebsiella Pneumoniae Strains (Crkp) Isolated From Ventilator-Associated Pneumoniae (Vap) Infection of Covid-19 Patients, Annals of Clinical Microbiology and Antimicrobials (2023)
4. Secondary Bacterial Infection Caused by St16 Ndm-1 and Oxa-48-Producing Colistin and Carbapenem-Resistant Klebsiella Pneumoniae Treated With Tigecycline in a Pregnant Woman With Covid-19, Journal of Pharmaceutical Policy and Practice (2023)
5. Comparative Genome Analysis of Colistin-Resistant Oxa-48-Producing Klebsiella Pneumoniae Clinical Strains Isolated From Two Iranian Hospitals, Annals of Clinical Microbiology and Antimicrobials (2021)
6. The Emergence of Blaoxa-48 and Blandm Among Esbl-Producing Klebsiella Pneumoniae in Clinical Isolates of a Tertiary Hospital in Iran, Acta Microbiologica et Immunologica Hungarica (2018)
7. High Rate of Carbapenem-Resistant Klebsiella Pneumoniae Detected From Hospital Equipments in Iran, Acta Microbiologica et Immunologica Hungarica (2018)
8. Prevalence of Blactx-M Gene Among Extended-Spectrum Β-Lactamases Producing Klebsiella Pneumoniae Clinical Isolates in Iran: A Meta-Analysis, Iranian Journal of Medical Sciences (2018)
Experts (# of related papers)
View all Related Experts
Hamid Solgi (16)
Hossein Fazeli (5)
Other Related Docs
9. Frequency Determination of Carbapenem-Resistant Klebsiella Pneumoniae (Crkp) Isolated From Hospitals in Isfahan of Iran and Evaluation of Synergistic Effect of Colistin and Meropenem on Them, Cellular and Molecular Biology (2018)
10. Molecular Epidemiology of Oxa-48 and Ndm-1 Producing Enterobacterales Species at a University Hospital in Tehran, Iran, Between 2015 and 2016, Frontiers in Microbiology (2020)
11. The Face of Hypervirulent Klebsiella Pneumoniae Isolated From Clinical Samples of Two Iranian Teaching Hospitals, Annals of Clinical Microbiology and Antimicrobials (2021)
12. Genome Analysis of an Oxa-48-Producing Carbapenem- and Colistin-Resistant Klebsiella Pneumoniae Sequence Type 11 Clone Isolated From an Inpatient, Gene Reports (2021)
13. Emergence of Colistin Resistant Acinetobacter Baumannii Clonal Complex 2 (Cc2) Among Hospitalized Patients in Iran, Acta Microbiologica et Immunologica Hungarica (2023)
14. Emergence of Carbapenem Resistant Escherichia Coli Isolates Producing Blandm and Blaoxa-48-Like Carried on Inca/C and Incl/M Plasmids at Two Iranian University Hospitals, Infection, Genetics and Evolution (2017)
15. Isolation and Identification of Carbapenemase Kpc Producing Strains of Enterobacteriaceae and Determination of Their Antibiotic Susceptibility Patterns, Journal of Isfahan Medical School (2013)
16. Comprehensive Pan-Genomic, Resistome and Virulome Analysis of Clinical Oxa-48 Producing Carbapenem-Resistant Serratia Marcescens Strains, Gene (2022)
17. Molecular Epidemiology of Colistin-Resistant Pseudomonas Aeruginosa Producing Ndm-1 From Hospitalized Patients in Iran, Iranian Journal of Basic Medical Sciences (2019)
18. Molecular Characterization and Phage Typing of Methicillin-Resistant Staphylococcus Aureus Isolated From Clinical Samples in Isfahan, Iran, Jundishapur Journal of Microbiology (2023)
19. Evaluating Antibiotic Resistance Pattern of Ventilator-Associated Pneumonia in Intensive Care Units of Alzahra Hospital, Isfahan University of Medical Sciences, Iran, Journal of Isfahan Medical School (2016)
20. The Emergence of Qnr-Resistance Among Klebsiella Pneumoniae Spp in Zahedan, Iranian Journal of Pharmaceutical Sciences (2018)
21. An Experimental in Silico Study on Covid-19: Response of Neutrophil-Related Genes to Antibiotics, Health Science Reports (2022)
22. Identification of Blaoxa−51−23−58, Blavim, Blandm, and Blaimp Carbapenemase Genes in Acinetobacter Baumannii Isolates From Hospitalized Patients, BMC Research Notes (2024)
23. Secondary Bacterial Infection and Clinical Characteristics in Patients With Covid-19 Admitted to Two Intensive Care Units of an Academic Hospital in Iran During the First Wave of the Pandemic, Frontiers in Cellular and Infection Microbiology (2022)
24. International Prevalence and Risk Factors Evaluation for Drug-Resistant Streptococcus Pneumoniae Pneumonia, Journal of Infection (2019)
25. Molecular Detection of Extended-Spectrum Β-Lactamases (Esbls) and Biofilm Formation in Uropathogen Klebsiella Pneumoniae in Iran, Medical Journal of the Islamic Republic of Iran (2021)
26. Assessment of Cage and Baba Mrna Expression During Morphological Conversion of Helicobacter Pylori From Spiral to Coccoid, Current Microbiology (2013)
27. Phenotypic and Molecular Characterization of Extended-Spectrum Β-Lactamase Produced by Escherichia Coli, and Klebsiella Pneumoniae Isolates in an Educational Hospital, Jundishapur Journal of Microbiology (2014)
28. Different Virulence Capabilities and Ompa Expressions in St2 and St513 of Multidrug-Resistant Acinetobacter Baumannii, Current Microbiology (2019)
29. Resistotyping, Phenotyping and Genotyping of New Delhi Metallo-Β-Lactamase (Ndm) Among Gram-Negative Bacilli From Iranian Patients, Journal of Medical Microbiology (2017)
30. Prevalence Incidence and Clinical Outcome of Klebsiella and Acinetobacter Ventilator-Associated Pneumonia, Immunopathologia Persa (2023)
31. Detection of New Delhi Metallo-Beta-Lactamase-1 (Ndm-1) in Carbapenem-Resistant Klebsiella Pneumoniae Isolated From a University Hospital in Iran, Hippokratia (2015)
32. A Comparison of Disk Diffusion Method and E-Test in Determining the Susceptibility and Resistance of Klebsiella and Acinetobacter Strains to Cefepime in Patients With Ventilator-Associated Pneumonia Admitted to the Intensive Care Unit, Immunopathologia Persa (2024)
33. Antimicrobial Susceptibility Pattern of Carbapenemase-Producing Gram-Negative Nosocomial Bacteria at Al Zahra Hospital, Isfahan, Iran, Iranian Journal of Microbiology (2021)
34. Laboratory Findings of Covid-19 Infection Are Conflicting in Different Age Groups and Pregnant Women: A Literature Review, Archives of Medical Research (2020)
35. Gut-Lung Microbiota Characterization in Patients With Non-Small Cell Lung Carcinoma and Covid-19 Coinfection, Archives of Iranian Medicine (2024)
36. Molecular Characterization of Intestinal Carriage of Carbapenem-Resistant Enterobacteriaceae Among Inpatients at Two Iranian University Hospitals: First Report of Co-Production of Bla Ndm-7 and Bla Oxa-48, European Journal of Clinical Microbiology and Infectious Diseases (2017)
37. Characterization of Hypervirulent Extended-Spectrum Β-Lactamase-Producing Klebsiella Pneumoniae Among Urinary Tract Infections: The First Report From Iran, Infection and Drug Resistance (2020)
38. Microbiological Testing of Adults Hospitalised With Community-Acquired Pneumonia: An International Study, ERJ Open Research (2018)
39. Macrolide-Resistant Mycoplasma Pneumoniae in an Iranian Pediatric Sample With Community-Acquired Pneumonia, Jundishapur Journal of Microbiology (2023)
40. Community-Acquired Pneumonia in Adults: A Mono-Center Retrospective Study, Tanaffos (2024)
41. Emergence of Carbapenem Resistant Acinetobacter Baumannii Clonal Complexes Cc2 and Cc10 Among Fecal Carriages in an Educational Hospital, International Journal of Environmental Health Research (2022)
42. Comparative Resistome and Virulome Analysis of Clinical Ndm-1–Producing Carbapenem-Resistant Enterobacter Cloacae Complex, Journal of Global Antimicrobial Resistance (2022)
43. Global Resistance of Imipenem/Relebactam Against Gram-Negative Bacilli: Systematic Review and Meta-Analysis, Current Therapeutic Research - Clinical and Experimental (2024)
44. Bacterial Infections and Outcomes of Inpatients With Covid-19 in the Intensive Care Unit During the Delta-Dominant Phase: The Worst Wave of Pandemic in Iran, Frontiers in Public Health (2024)