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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; Shelenkov, Andrey; Yanushevich, Yuri; Mikhaylova, Yulia; Shagin, Dmitriy; Alexandrova, Irina; Ershova, Olga; Akimkin, Vasiliy; Kozlov, Roman; Edelstein, Mikhail. 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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