Abstract
Two metallo-β-lactamase-producing Klebsiella pneumoniae (HA30 and HA31) were isolated in a hospital in Argentina during 2018. K. pneumoniae HA30 was isolated from a rectal swab during the epidemiological surveillance for carbapenemase-producing strains, while K. pneumoniae HA31 was collected from the same patient 4 days after hospitalization. The aim of the present study was to identify the clonal relationships and resistome of these two NDM-producing K. pneumoniae strains isolated from a patient with a fatal outcome. Whole-genome sequencing (WGS) was performed using Illumina MiSeq-I, and subsequent analysis involved genome assembly, annotation, antibiotic resistance gene identification, multilocus sequence typing (MLST), and plasmid characterization using bioinformatics tools. Conjugation assays to E. coli J53 was conducted as previously described. K. pneumoniae HA30 exhibited extensively drug-resistant phenotype, while HA31 was multidrug-resistant as defined by Magiorakos et al., including both resistance to carbapenems, aminoglycosides and ciprofloxacin with blaNDM-5, blaCTX-M-15 and rmtB genes found in both strains. MLST analysis showed that both strains belonged to ST11, differing by only 4 cgSNPs, indicating that K. pneumoniae HA30 and HA31 were the same strain. Conjugation assays revealed that K. pneumoniae HA31 strain possessed a transferable plasmid to E. coli J53. Bioinformatics studies identified that the same strain colonizing an inpatient during hospital admission subsequently caused the infection leading to a fatal outcome, being the first report of blaNDM-5, rmtB and blaCTX-M-15 genes in a K. pneumoniae ST11 strain from Latin America. Our results also highlighted the importance of focusing on epidemiological surveillance programs.
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Funding
This work was supported by grant ISID/Pfizer 2019 given to DC, the grant PUE 2522 from CONICET given to IMPaM (UBA/CONICET), UBACYT Programación Científica 2018 given to DC and MPQ, PICT- 2021-I-INVI-00790 given to VEA, and PICT 2021 (1120) given to DC. DC and MPQ are members of the Carrera del Investigador Científico, CONICET, Argentina. NGA is an infectious diseases doctor. BF and LFC are clinical microbiology specialists. LCP is recipient of a CONICET doctoral fellowship. MP is recipient of an Universidad de Buenos Aires´s fellowship.
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Conceptualization: DC; Methodology: VEÁ, LCP, MP, NGA, JC, BF and LF-C; Formal analysis and investigation: VEÁ, LCP, NM, AA, LF-C, MPQ and DC; Writing—original draft preparation: DC; Writing—review and editing: DC and VEÁ; Funding acquisition: DC, VEÁ and MPQ; Resources: DC and MPQ; Supervision: DC. All authors read and approved the final manuscript.
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Álvarez, V.E., Carrera Páez, L., Piekar, M. et al. Genomic Characterization of Two NDM-5-Producing Isolates of Klebsiella pneumoniae ST11 from a Single Patient. Curr Microbiol 81, 76 (2024). https://doi.org/10.1007/s00284-023-03596-3
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DOI: https://doi.org/10.1007/s00284-023-03596-3