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  2. An unequivocal superbug: PDR Klebsiella pneumoniae with an arsenal of resistance and virulence factor genes

An unequivocal superbug: PDR Klebsiella pneumoniae with an arsenal of resistance and virulence factor genes

  • J Infect Dev Ctries. 2021 Mar 31;15(3):404-414. doi: 10.3855/jidc.13573.
Ahmad Sleiman 1 Bassel Awada 1 Michele Mocadie 2 Nour Sherri 1 Louis-Patrick Haraoui 3 Vincent Baby 3 George F Araj 4 Souha S Kanj 4 Nesrine Rizk 4 Ghassan M Matar 1 Antoine G Abou Fayad 5
Affiliations

Affiliations

  • 1 Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
  • 2 Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
  • 3 Department of Microbiology and Infectious Diseases, University of Sherbrooke, Sherbrooke, QC, Canada.
  • 4 Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon.
  • 5 Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon. aa328@aub.edu.lb.
Abstract

Introduction: Infections caused by extensively-drug resistant (XDR) and pan-drug resistant (PDR) Klebsiella pneumoniae represent an emerging threat due to the high associated mortality. This study aimed to characterize two carbapenem resistant K. pneumoniae strains from the same patient, the first being PDR (referred to as IMP 1078b) and the second being XDR (referred to IMP 1078s) isolated from the same patient.

Methodology: Antimicrobial susceptibility testing was done for the 2 K. pneumoniae isolates, followed by carbapenem/β-lactamase inhibitor combination assay, and fitness cost against cefepime and meropenem. Then, whole-genome sequence analysis was performed to decipher the molecular mechanisms behind the high level of resistance recorded in both isolates. Finally, qRT-PCR was done for β-lactam resistant genes.

Results: This is the first report about a K. pneumoniae isolate harboring 47 antimicrobial resistance genes and having type IV pilli (Yersinia) and the fimbrial adherence determinant Stb (Salmonella) as virulence factors. Further analysis on both isolates are discussed within the article.

Conclusion: The co-existence of a high number of antimicrobial resistant (AMR) genes and virulence factor genes may lead to a life threatening invasive and untreatable Infection.

Keywords

AMR; K. pneumoniae; NDM; OXA; PDR; XDR.

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