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Communication

Antimicrobial Resistance and Genomic Characterization of OXA-48- and CTX-M-15-Co-Producing Hypervirulent Klebsiella pneumoniae ST23 Recovered from Nosocomial Outbreak

1
Institute of Antimicrobial Chemotherapy, Smolensk State Medical University, 214019 Smolensk, Russia
2
Institute of Fundamental Medicine and Biology, Kazan Federal University, 420012 Kazan, Russia
3
Central Research Institute of Epidemiology, Rospotrebnadzor, 111123 Moscow, Russia
4
Pirogov Russian National Research Medical University, 117997 Moscow, Russia
5
N.N. Burdenko National Scientific and Practical Center for Neurosurgery, 125047 Moscow, Russia
*
Author to whom correspondence should be addressed.
Received: 13 November 2020 / Revised: 27 November 2020 / Accepted: 1 December 2020 / Published: 3 December 2020
(This article belongs to the Special Issue Antimicrobial Resistance in Gram-Negative Bacteria, 2nd Edition)
Multidrug resistance (MDR) and hypervirulence (hv) have been long considered distinct evolutionary traits for Klebsiella pneumoniae (Kp), a versatile human pathogen. The recent emergence of Kp strains combining these traits poses a serious global threat. In this article, we describe the phenotypic and genomic characteristics of an MDR hvKp isolate, MAR14-456, representative of a nosocomial outbreak in Moscow, Russia, that was recovered from a postoperative wound in a patient who later developed multiple abscesses, fatal sepsis, and septic shock. Broth microdilution testing revealed decreased susceptibility of MAR14-456 to carbapenems (MICs 0.5–2 mg/L) and a high-level resistance to most β-lactams, β-lactam-β-lactamase-inhibitor combinations, and non-β-lactam antibiotics, except ceftazidime-avibactam, amikacin, tigecycline, and colistin. Whole-genome sequencing using Illumina MiSeq and ONT MinION systems allowed to identify and completely assemble two conjugative resistance plasmids, a typical ‘European’ epidemic IncL/M plasmid that carries the gene of OXA-48 carbapenemase, and an IncFIIK plasmid that carries the gene of CTX-M-15 ESBL and other resistance genes. MLST profile, capsular, lipopolysaccharide, virulence genes encoded on chromosome and IncHI1B/FIB plasmid, and the presence of apparently functional type I-E* CRISPR-Cas system were all characteristic of hvKp ST23, serotype K1-O1v2. Phylogenetic analysis showed the closest relatedness of MAR14-456 to ST23 isolates from China. This report highlights the threat of multiple resistance acquisition by hvKp strain and its spread as a nosocomial pathogen. View Full-Text
Keywords: Klebsiella pneumoniae; OXA-48; hypervirulent ST23; multidrug resistance; whole-genome sequencing Klebsiella pneumoniae; OXA-48; hypervirulent ST23; multidrug resistance; whole-genome sequencing
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MDPI and ACS Style

Shaidullina, E.; Shelenkov, A.; Yanushevich, Y.; Mikhaylova, Y.; Shagin, D.; Alexandrova, I.; Ershova, O.; Akimkin, V.; Kozlov, R.; Edelstein, M. Antimicrobial Resistance and Genomic Characterization of OXA-48- and CTX-M-15-Co-Producing Hypervirulent Klebsiella pneumoniae ST23 Recovered from Nosocomial Outbreak. Antibiotics 2020, 9, 862. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9120862

AMA Style

Shaidullina E, Shelenkov A, Yanushevich Y, Mikhaylova Y, Shagin D, Alexandrova I, Ershova O, Akimkin V, Kozlov R, Edelstein M. Antimicrobial Resistance and Genomic Characterization of OXA-48- and CTX-M-15-Co-Producing Hypervirulent Klebsiella pneumoniae ST23 Recovered from Nosocomial Outbreak. Antibiotics. 2020; 9(12):862. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9120862

Chicago/Turabian Style

Shaidullina, Elvira, Andrey Shelenkov, Yuri Yanushevich, Yulia Mikhaylova, Dmitriy Shagin, Irina Alexandrova, Olga Ershova, Vasiliy Akimkin, Roman Kozlov, and Mikhail Edelstein. 2020. "Antimicrobial Resistance and Genomic Characterization of OXA-48- and CTX-M-15-Co-Producing Hypervirulent Klebsiella pneumoniae ST23 Recovered from Nosocomial Outbreak" Antibiotics 9, no. 12: 862. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9120862

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