Molecular Profiling of a Multi-Strain Hypervirulent Klebsiella pneumoniae Infection Within a Single Patient

References

• Ashurst JV, Dawson A. Klebsiella Pneumonia. Treasure Island (FL): StatPearls; 2022.
   Google Scholar
• Wang G, Zhao G, Chao X, Xie L, Wang H. The Characteristic of Virulence, Biofilm and Antibiotic Resistance of Klebsiella pneumoniae. Int J Environ Res Public Health. 2020;17:17.
   Web of Science ®Google Scholar
• Liang S, Cao H, Ying F, Zhang C. Report of a Fatal Purulent Pericarditis Case Caused by ST11-K64 Carbapenem-Resistant Hypervirulent Klebsiella pneumoniae. Infect Drug Resist. 2022;15:4749–4757.
   PubMed Web of Science ®Google Scholar
• Chang SL, Dela Cruz CS, Zhang D. Clinical Epidemiology, Risk Factors, and Control Strategies of Klebsiella pneumoniae Infection. Front Microbiol. 2021;12:750662.
   PubMed Web of Science ®Google Scholar
• Queenan AM, Bush K. Carbapenemases: the versatile beta-lactamases. Clin Microbiol Rev. 2007;20(3):440–458.
   PubMed Web of Science ®Google Scholar
• Lee GC, Burgess DS. Treatment of Klebsiella pneumoniae carbapenemase (KPC) infections: a review of published case series and case reports. Ann Clin Microbiol Antimicrob. 2012;11:32.
   PubMed Web of Science ®Google Scholar
• Clegg S, Murphy CN. Epidemiology and Virulence of Klebsiella pneumoniae. Microbiol Spectr. 2016;4(1):548.
   Web of Science ®Google Scholar
• Hirai J, Sakanashi D, Kinjo T, Haranaga S, Fujita J. The First Case of Community-Acquired Pneumonia Due to Capsular Genotype K2-ST86 Hypervirulent Klebsiella pneumoniae in Okinawa, Japan: a Case Report and Literature Review. Infect Drug Resist. 2020;13:2237–2243.
   PubMed Web of Science ®Google Scholar
• Shon AS, Bajwa RP, Russo TA. Hypervirulent (hypermucoviscous) Klebsiella pneumoniae: a new and dangerous breed. Virulence. 2013;4(2):107–118.
   PubMed Web of Science ®Google Scholar
• Russo TA, Marr CM. Hypervirulent Klebsiella pneumoniae. Clin Microbiol Rev. 2019;32(3). doi:10.1128/CMR.00001-19
   PubMed Web of Science ®Google Scholar
• Choby JE, Howard‐Anderson J, Weiss DS. Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives. J Intern Med. 2020;287(3):283–300. doi:10.1111/joim.13007
   PubMed Web of Science ®Google Scholar
• Russo TA, MacDonald U, Hassan S, et al. An Assessment of Siderophore Production, Mucoviscosity, and Mouse Infection Models for Defining the Virulence Spectrum of Hypervirulent Klebsiella pneumoniae. mSphere. 2021;6(2). doi:10.1128/mSphere.00045-21.
   Web of Science ®Google Scholar
• Russo TA, Olson R, Fang CT, et al. Identification of Biomarkers for Differentiation of Hypervirulent Klebsiella pneumoniae from Classical K. pneumoniae. J Clin Microbiol. 2018;56(9):98.
   Web of Science ®Google Scholar
• Yang X, Dong N, Chan EW, Zhang R, Chen S. Carbapenem Resistance-Encoding and Virulence-Encoding Conjugative Plasmids in Klebsiella pneumoniae. Trends Microbiol. 2021;29(1):65–83.
   PubMed Web of Science ®Google Scholar
• Heiden SE, Hubner NO, Bohnert JA, et al. A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition. Genome Med. 2020;12(1):113.
   PubMed Web of Science ®Google Scholar
• Martin MJ, Corey BW, Sannio F, et al. Anatomy of an extensively drug-resistant Klebsiella pneumoniae outbreak in Tuscany, Italy. Proc Natl Acad Sci U S A. 2021;118(48):54.
   Web of Science ®Google Scholar
• Lee CM, Liao CH, Lee WS, et al. Outbreak of Klebsiella pneumoniae carbapenemase-2-producing K. pneumoniae sequence type 11 in Taiwan in 2011. Antimicrob Agents Chemother. 2012;56(10):5016–5022.
   PubMed Web of Science ®Google Scholar
• Chen C, Zhang Y, Yu SL, et al. Tracking Carbapenem-Producing Klebsiella pneumoniae Outbreak in an Intensive Care Unit by Whole Genome Sequencing. Front Cell Infect Microbiol. 2019;9:281.
   PubMed Web of Science ®Google Scholar
• Snitkin ES, Zelazny AM, Thomas PJ, et al. Tracking a hospital outbreak of carbapenem-resistant Klebsiella pneumoniae with whole-genome sequencing. Sci Transl Med. 2012;4(148):148ra116.
   PubMed Web of Science ®Google Scholar
• Cortes-Ortiz IA, Juarez-Gomez JC, Cu-Quijano C, et al. Klebsiella pneumoniae blaNDM-1 carrying a class 1 integron causing a hospital outbreak in a Mexican attention center. J Infect Dev Ctries. 2021;15(5):657–664.
   PubMed Web of Science ®Google Scholar
• Ochonska D, Scibik L, Brzychczy-Wloch M. Biofilm Formation of Clinical Klebsiella pneumoniae Strains Isolated from Tracheostomy Tubes and Their Association with Antimicrobial Resistance, Virulence and Genetic Diversity. Pathogens. 2021;10(10):87.
   PubMed Web of Science ®Google Scholar
• Wyres KL, Holt KE. Klebsiella pneumoniae as a key trafficker of drug resistance genes from environmental to clinically important bacteria. Curr Opin Microbiol. 2018;45:131–139.
   PubMed Web of Science ®Google Scholar
• Jenkins S, Ledeboer NA, Westblade LF, et al. Evaluation of NG-Test Carba 5 for Rapid Phenotypic Detection and Differentiation of Five Common Carbapenemase Families: results of a Multicenter Clinical Evaluation. J Clin Microbiol. 2020;58(7):87.
   Web of Science ®Google Scholar
• Indrajith S, Mukhopadhyay AK, Chowdhury G, et al. Molecular insights of Carbapenem resistance Klebsiella pneumoniae isolates with focus on multidrug resistance from clinical samples. J Infect Public Health. 2021;14(1):131–138.
   PubMed Web of Science ®Google Scholar
• Yu F, Lv J, Niu S, et al. Multiplex PCR Analysis for Rapid Detection of Klebsiella pneumoniae Carbapenem-Resistant (Sequence Type 258 [ST258] and ST11) and Hypervirulent (ST23, ST65, ST86, and ST375) Strains. J Clin Microbiol. 2018;56(9):9.
   Web of Science ®Google Scholar
• Duan H, Chai T, Liu J, et al. Source identification of airborne Escherichia coli of swine house surroundings using ERIC-PCR and REP-PCR. Environ Res. 2009;109(5):511–517.
   PubMed Web of Science ®Google Scholar
• Zhang S, Yang G, Ye Q, Wu Q, Zhang J, Huang Y. Phenotypic and Genotypic Characterization of Klebsiella pneumoniae Isolated From Retail Foods in China. Front Microbiol. 2018;9:289.
   PubMed Web of Science ®Google Scholar
• Liu Y, Liu PP, Wang LH, Wei DD, Wan LG, Zhang W. Capsular Polysaccharide Types and Virulence-Related Traits of Epidemic KPC-Producing Klebsiella pneumoniae Isolates in a Chinese University Hospital. Microb Drug Resist. 2017;23(7):901–907.
   PubMed Web of Science ®Google Scholar
• Du Q, Pan F, Wang C, et al. Nosocomial dissemination of hypervirulent Klebsiella pneumoniae with high-risk clones among children in Shanghai. Front Cell Infect Microbiol. 2022;12:984180.
   PubMed Web of Science ®Google Scholar
• Shakil S, Azhar EI, Tabrez S, et al. New Delhi metallo-beta-lactamase (NDM-1): an update. J Chemother. 2011;23(5):263–265.
   PubMed Web of Science ®Google Scholar
• Zhang S, Zhang X, Wu Q, et al. Clinical, microbiological, and molecular epidemiological characteristics of Klebsiella pneumoniae-induced pyogenic liver abscess in southeastern China. Antimicrob Resist Infect Control. 2019;8:166.
   PubMed Web of Science ®Google Scholar
• Fu L, Huang M, Zhang X, et al. Frequency of virulence factors in high biofilm formation blaKPC-2 producing Klebsiella pneumoniae strains from hospitals. Microb Pathog. 2018;116:168–172.
   PubMed Web of Science ®Google Scholar
• Zhan L, Wang S, Guo Y, et al. Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China. Front Cell Infect Microbiol. 2017;7:182.
   PubMed Web of Science ®Google Scholar
• Gasink LB, Edelstein PH, Lautenbach E, Synnestvedt M, Fishman NO. Risk factors and clinical impact of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae. Infect Control Hosp Epidemiol. 2009;30(12):1180–1185.
   PubMed Web of Science ®Google Scholar
• Karlowsky JA, Kazmierczak KM, de Jonge BLM, Hackel MA, Sahm DF, Bradford PA. In Vitro Activity of Aztreonam-Avibactam against Enterobacteriaceae and Pseudomonas aeruginosa Isolated by Clinical Laboratories in 40 Countries from 2012 to 2015. Antimicrob Agents Chemother. 2017;61(9):9.
   Web of Science ®Google Scholar
• Bocanegra-Ibarias P, Camacho-Ortiz A, Garza-Gonzalez E, Flores-Trevino S, Kim H, Perez-Alba E. Aztreonam plus ceftazidime-avibactam as treatment of NDM-1-producing Klebsiella pneumoniae bacteraemia in a neutropenic patient: last resort therapy? J Glob Antimicrob Resist. 2020;23:417–419.
   PubMed Web of Science ®Google Scholar
• Freire AT, Melnyk V, Kim MJ, et al. Comparison of tigecycline with imipenem/cilastatin for the treatment of hospital-acquired pneumonia. Diagn Microbiol Infect Dis. 2010;68(2):140–151.
   PubMed Web of Science ®Google Scholar
• Ontong JC, Ozioma NF, Voravuthikunchai SP, Chusri S. Synergistic antibacterial effects of colistin in combination with aminoglycoside, carbapenems, cephalosporins, fluoroquinolones, tetracyclines, fosfomycin, and piperacillin on multidrug resistant Klebsiella pneumoniae isolates. PLoS One. 2021;16(1):e0244673.
   PubMed Web of Science ®Google Scholar
• Gurjar M. Colistin for lung infection: an update. J Intensive Care. 2015;3(1):3.
   PubMedGoogle Scholar
• Hu L, Liu Y, Deng L, et al. Outbreak by Ventilator-Associated ST11 K. pneumoniae with Co-production of CTX-M-24 and KPC-2 in a SICU of a Tertiary Teaching Hospital in Central China. Front Microbiol. 2016;7:1190.
   PubMed Web of Science ®Google Scholar
• Sanikhani R, Moeinirad M, Shahcheraghi F, et al. Molecular epidemiology of hypervirulent Klebsiella pneumoniae: a systematic review and meta-analysis. Iran J Microbiol. 2021;13(3):257–265.
   PubMed Web of Science ®Google Scholar
• Qi Y, Wei Z, Ji S, Du X, Shen P, Yu Y. ST11, the dominant clone of KPC-producing Klebsiella pneumoniae in China. J Antimicrob Chemother. 2011;66(2):307–312.
   PubMed Web of Science ®Google Scholar
• Chiang MK, Hsiao PY, Liu YY, et al. Two ST11 Klebsiella pneumoniae strains exacerbate colorectal tumorigenesis in a colitis-associated mouse model. Gut Microbes. 2021;13(1):1980348.
   PubMed Web of Science ®Google Scholar
• Xiong L, Su L, Tan H, et al. Molecular Epidemiological Analysis of ST11-K64 Extensively Drug-Resistant Klebsiella pneumoniae Infections Outbreak in Intensive Care and Neurosurgery Units Based on Whole-Genome Sequencing. Front Microbiol. 2021;12:709356.
   PubMed Web of Science ®Google Scholar
• Yang Q, Jia X, Zhou M, et al. Emergence of ST11-K47 and ST11-K64 hypervirulent carbapenem-resistant Klebsiella pneumoniae in bacterial liver abscesses from China: a molecular, biological, and epidemiological study. Emerg Microbes Infect. 2020;9(1):320–331.
   PubMed Web of Science ®Google Scholar
• Wei T, Zou C, Qin J, et al. Emergence of Hypervirulent ST11-K64 Klebsiella pneumoniae Poses a Serious Clinical Threat in Older Patients. Front Public Health. 2022;10:765624.
   PubMed Web of Science ®Google Scholar
• Franklin-Alming FV, Kaspersen H, Hetland MAK, et al. Exploring Klebsiella pneumoniae in Healthy Poultry Reveals High Genetic Diversity, Good Biofilm-Forming Abilities and Higher Prevalence in Turkeys Than Broilers. Front Microbiol. 2021;12:725414.
   PubMedGoogle Scholar
• Raffelsberger N, Hetland MAK, Svendsen K, et al. Gastrointestinal carriage of Klebsiella pneumoniae in a general adult population: a cross-sectional study of risk factors and bacterial genomic diversity. Gut Microbes. 2021;13(1):1939599.
   PubMed Web of Science ®Google Scholar
• Shimasaki T, Seekatz A, Bassis C, et al. Increased Relative Abundance of Klebsiella pneumoniae Carbapenemase-producing Klebsiella pneumoniae Within the Gut Microbiota Is Associated With Risk of Bloodstream Infection in Long-term Acute Care Hospital Patients. Clin Infect Dis. 2019;68(12):2053–2059.
   PubMed Web of Science ®Google Scholar
• Marcade G, Brisse S, Bialek S, et al. The emergence of multidrug-resistant Klebsiella pneumoniae of international clones ST13, ST16, ST35, ST48 and ST101 in a teaching hospital in the Paris region. Epidemiol Infect. 2013;141(8):1705–1712.
   PubMed Web of Science ®Google Scholar
• Alsharapy SA, Gharout-Sait A, Muggeo A, et al. Characterization of Carbapenem-Resistant Enterobacteriaceae Clinical Isolates in Al Thawra University Hospital, Sana’a, Yemen. Microb Drug Resist. 2020;26(3):211–217.
   PubMed Web of Science ®Google Scholar
• Shen Z, Gao Q, Qin J, Liu Y, Li M. Emergence of an NDM-5-Producing Hypervirulent Klebsiella pneumoniae Sequence Type 35 Strain with Chromosomal Integration of an Integrative and Conjugative Element, ICEKp1. Antimicrob Agents Chemother. 2019;64(1):1–54.
   Web of Science ®Google Scholar
• Zhu J, Wang T, Chen L, Du H. Virulence Factors in Hypervirulent Klebsiella pneumoniae. Front Microbiol. 2021;12:642484.
   PubMed Web of Science ®Google Scholar
• Dong N, Yang X, Chan EW, Zhang R, Chen S. Klebsiella species: taxonomy, hypervirulence and multidrug resistance. EBioMedicine. 2022;79:103998.
   PubMed Web of Science ®Google Scholar
• Lee IR, Molton JS, Wyres KL, et al. Differential host susceptibility and bacterial virulence factors driving Klebsiella liver abscess in an ethnically diverse population. Sci Rep. 2016;6:29316.
   PubMed Web of Science ®Google Scholar
• Cheng NC, Yu YC, Tai HC, et al. Recent trend of necrotizing fasciitis in Taiwan: focus on monomicrobial Klebsiella pneumoniae necrotizing fasciitis. Clin Infect Dis. 2012;55(7):930–939.
   PubMed Web of Science ®Google Scholar
• Munita JM, Arias CA. Mechanisms of Antibiotic Resistance. Microbiol Spectr. 2016;4(2):98.
   Web of Science ®Google Scholar
• Russo TA, Olson R, MacDonald U, Beanan J, Davidson BA. Aerobactin, but not yersiniabactin, salmochelin, or enterobactin, enables the growth/survival of hypervirulent (hypermucoviscous) Klebsiella pneumoniae ex vivo and in vivo. Infect Immun. 2015;83(8):3325–3333.
   PubMed Web of Science ®Google Scholar
• Carrasco-Anabalon S, Conceicao Neto CO, D’Alincourt Carvalho-Assef AP, et al. Introduction of NDM-1 and OXA-370 from Brazil into Chile in strains of Klebsiella pneumoniae isolated from a single patient. Int J Infect Dis. 2019;81:28–30.
   PubMed Web of Science ®Google Scholar
• Lee H, Shin J, Chung YJ, et al. Evolution of Klebsiella pneumoniae with mucoid and non-mucoid type colonies within a single patient. Int J Med Microbiol. 2019;309(3–4):194–198.
   PubMed Web of Science ®Google Scholar
• Ponnusamy D, Kozlova EV, Sha J, et al. Cross-talk among flesh-eating Aeromonas hydrophila strains in mixed infection leading to necrotizing fasciitis. Proc Natl Acad Sci U S A. 2016;113(3):722–727.
   PubMed Web of Science ®Google Scholar
• Fernandez-Bravo A, Kilgore PB, Andersson JA, et al. T6SS and ExoA of flesh-eating Aeromonas hydrophila in peritonitis and necrotizing fasciitis during mono- and polymicrobial infections. Proc Natl Acad Sci U S A. 2019;116(48):24084–24092.
   PubMed Web of Science ®Google Scholar
• Grim CJ, Kozlova EV, Ponnusamy D, et al. Functional genomic characterization of virulence factors from necrotizing fasciitis-causing strains of Aeromonas hydrophila. Appl Environ Microbiol. 2014;80(14):4162–4183.
   PubMed Web of Science ®Google Scholar