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Pathogens
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Infection and Antimicrobial Resistance of Klebsiella pneumoniae
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Infection and Antimicrobial Resistance of Klebsiella pneumoniae

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Bacterial Pathogens".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 18638

Special Issue Editor

Prof. Dr. Thomas Guillard

E-Mail Website
Guest Editor
Department of Clinical Microbiology, Reims Teaching Hospital, Inserm UMR-S 1250 P3Cell, Champagne-Ardenne University, Reims, France
Interests: Antibiotic resistance and virulence; airway epithelium

Special Issue Information

Dear Colleagues,

Klebsiella pneumoniae is a major pathogen that causes a wide range of infections, such as urinary tract infections and pneumonia, which may lead to severe sepsis and death. Moreover, the hypervirulent K. pneumoniae (hvKp) pathotype is responsible of life-threatening invasive diseases, such as liver abscesses.

K. pneumoniae is an ESKAPE pathogen and the efficacy of common antibiotics is compromised by the widespread acquisition of antimicrobial resistance (AMR) genes, such as extended-spectrum β-lactamases- and carbapenemases-encoding genes. Notably, among Enterobacterales resistant to carbapenem, carbapenem-resistant K. pneumoniae strains are the most clinically prominent. Interestingly, K. pneumoniae is considered to be a key trafficker of drug resistance genes.

Effective antimicrobial options are often lacking, and treatment can rely on last resort antibiotics, such as colistin. Unfortunately, these options are threatened by the incredible armamentarium of K. pneumoniae, allowing clinical strains to be adapted to hospital environments. In line with this, antiseptics resistance is of concern when it comes to K. pneumoniae, since exposure to chlorhexidine has been reported to increase resistance to this bis-biguanide antiseptic, along with cross-resistance to colistin.

It is clear that any future success towards fighting K. pneumoniae infections will require that we increase our knowledge of the molecular pathogenesis and antimicrobial/antiseptic resistance of this pathogen. This will help us to find alternative treatment options that are urgently required.

For this Special Issue of Pathogens, we invite you to submit a review article/original research article related to infection and antimicrobial/antiseptic resistance of K. pneumoniae. We look forward to your contribution.

Prof. Dr. Thomas Guillard
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (6 papers)

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24 pages, 3846 KiB  
Article
The In Vitro Ability of Klebsiella pneumoniae to Form Biofilm and the Potential of Various Compounds to Eradicate It from Urinary Catheters
by Monika Oleksy-Wawrzyniak, Adam Junka, Malwina Brożyna, Migdał Paweł, Bartłomiej Kwiek, Maciej Nowak, Beata Mączyńska and Marzenna Bartoszewicz
Pathogens 2022, 11(1), 42; https://doi.org/10.3390/pathogens11010042 - 31 Dec 2021
Cited by 9 | Viewed by 3096
Abstract
Urinary infections related to the presence of bacterial biofilm on catheters are responsible for loss of patients’ health and, due to their high frequency of occurrence, generate a significant economic burden for hospitals. Klebsiella pneumoniae is a pathogen frequently isolated from this type [...] Read more.
Urinary infections related to the presence of bacterial biofilm on catheters are responsible for loss of patients’ health and, due to their high frequency of occurrence, generate a significant economic burden for hospitals. Klebsiella pneumoniae is a pathogen frequently isolated from this type of infection. In this study, using a cohesive set of techniques performed under stationary and flow conditions, we assessed the ability of 120 K. pneumoniae strains to form biofilm on various surfaces, including catheters, and evaluated the usefulness of clinically applied and experimental compounds to remove biofilm. The results of our study indicate the high impact of intraspecies variability with respect to K. pneumoniae biofilm formation and its susceptibility to antimicrobials and revealed the crucial role of mechanical flushing out of the biofilm from the catheter’s surface with use of locally active antimicrobials. Therefore, our work, although of in vitro character, may be considered an important step in the direction of efficient reduction of K. pneumoniae biofilm-related hospital infections associated with the presence of urine catheters. Full article
(This article belongs to the Special Issue Infection and Antimicrobial Resistance of Klebsiella pneumoniae)
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7 pages, 1141 KiB  
Communication
Outbreak of CTX-M-15 Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae ST394 in a French Intensive Care Unit Dedicated to COVID-19
by Cécile Emeraud, Samy Figueiredo, Rémy A. Bonnin, Mouna Khecharem, Souad Ouzani, Pierre-Etienne Leblanc, Agnès B. Jousset, Nicolas Fortineau, Jacques Duranteau and Laurent Dortet
Pathogens 2021, 10(11), 1426; https://doi.org/10.3390/pathogens10111426 - 4 Nov 2021
Cited by 16 | Viewed by 2315
Abstract
Infections caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) are constantly rising worldwide and are often reported as causative agent of outbreaks in intensive care units (ICUs). During the first wave of the COVID-19 pandemic, bacterial cross-transmission was thought unlikely to occur due to [...] Read more.
Infections caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) are constantly rising worldwide and are often reported as causative agent of outbreaks in intensive care units (ICUs). During the first wave of the COVID-19 pandemic, bacterial cross-transmission was thought unlikely to occur due to the reinforcement of hygiene measures and prevention control. However, we report here an ESBL-producing K. pneumoniae (ST394) isolate responsible for a nosocomial outbreak in an ICU dedicated to COVID-19 patients. Full article
(This article belongs to the Special Issue Infection and Antimicrobial Resistance of Klebsiella pneumoniae)
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15 pages, 2141 KiB  
Article
Genetic Analysis, Population Structure, and Characterisation of Multidrug-Resistant Klebsiella pneumoniae from the Al-Hofuf Region of Saudi Arabia
by Lorina I. Badger-Emeka, Abdulrahman A. Al-Sultan, Marie Fe F. Bohol, Mashael R. Al-Anazi and Ahmed A. Al-Qahtani
Pathogens 2021, 10(9), 1097; https://doi.org/10.3390/pathogens10091097 - 28 Aug 2021
Cited by 9 | Viewed by 2571
Abstract
Multidrug-resistant Klebsiella pneumoniae (MDR-KP) is a major public health problem that is globally associated with disease outbreaks and high mortality rates. As the world seeks solutions to such pathogens, global and regional surveillance is required. The aim of the present study was to [...] Read more.
Multidrug-resistant Klebsiella pneumoniae (MDR-KP) is a major public health problem that is globally associated with disease outbreaks and high mortality rates. As the world seeks solutions to such pathogens, global and regional surveillance is required. The aim of the present study was to examine the antimicrobial susceptibility pattern and clonal relatedness of Klebsiella pneumoniae isolates collected for a period of three years through pulse field gel electrophoresis (PFGE). Isolate IDs, antimicrobial assays, ESBL-production, and minimum inhibitory concentrations (MICs) were examined with the Vitek 2 Compact Automated System. IDs were confirmed by 16S rRNA gene sequencing, with the resulting sequences being deposited in NCBI databases. DNA was extracted and resistance genes were detected by PCR amplification with appropriate primers. Isolates were extensive (31%) and multidrug-resistant (65%). Pulsotype clusters grouped the isolates into 22 band profiles that showed no specific pattern with phenotypes. Of the isolates, 98% were ESBL-KP, 69% were carbapenem-resistant Enterobacteriaceae (CRE) strains, and 72.5% comprised the carriage of two MBLs (SIM and IMP). Integrons (ISAba1, ISAba2, and IS18) were detected in 69% of the MDR-KP. Additionally, OXA-23 was detected in 67% of the isolates. This study therefore demonstrates clonal diversity among clinical K. pneumoniae, confirming that this bacterium has access to an enormous pool of genes that confer high resistance-developing potential. Full article
(This article belongs to the Special Issue Infection and Antimicrobial Resistance of Klebsiella pneumoniae)
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11 pages, 4114 KiB  
Article
Genome-Based Analysis of Klebsiella spp. Isolates from Animals and Food Products in Germany, 2013–2017
by Kathleen Klaper, Jens Andre Hammerl, Jörg Rau, Yvonne Pfeifer and Guido Werner
Pathogens 2021, 10(5), 573; https://doi.org/10.3390/pathogens10050573 - 8 May 2021
Cited by 20 | Viewed by 3871
Abstract
The increase in infections with multidrug-resistant and virulent Klebsiella pneumoniae (K. pneumoniae) strains poses a serious threat to public health. However, environmental reservoirs and routes of transmission for Klebsiella spp. that cause infections in humans and in livestock animals are not [...] Read more.
The increase in infections with multidrug-resistant and virulent Klebsiella pneumoniae (K. pneumoniae) strains poses a serious threat to public health. However, environmental reservoirs and routes of transmission for Klebsiella spp. that cause infections in humans and in livestock animals are not well understood. In this study, we aimed to analyze the distribution of antibiotic resistance genes and important virulence determinants (ybt, clb, iro, iuc, rmpA/A2) among 94 Klebsiella spp. isolates from different animal and food sources isolated between 2013 and 2017 in Germany. Antibiotic susceptibility testing was performed, and the genomes were sequenced by Illumina and Nanopore technology. Genetic relationships were assessed by conducting core genome multilocus sequence typing (cgMLST). Kleborate was used to predict resistance and virulence genes; Kaptive was used to derive the capsule types. The results revealed that 72 isolates (76.6%) belonged to the K. pneumoniae sensu lato complex. Within this complex, 44 known sequence types (STs), 18 new STs, and 38 capsule types were identified. Extended-spectrum beta-lactamase (ESBL) genes were detected in 16 isolates (17.0%) and colistin resistance in one (1.1%) K. pneumoniae isolate. Virulence genes were found in 22 K. pneumoniae isolates. Overall, nine (9.6%) and 18 (19.1%) isolates possessed the genes ybt and iuc, respectively. Notably, aerobactin (iuc lineage 3) was only detected in K. pneumoniae isolates from domestic pigs and wild boars. This study provides a snapshot of the genetic diversity of Klebsiella spp. in animals and food products in Germany. The siderophore aerobactin was found to be more prevalent in K. pneumoniae strains isolated from pigs than other sources. Further investigations are needed to evaluate if pigs constitute a reservoir for iuc lineage 3. Full article
(This article belongs to the Special Issue Infection and Antimicrobial Resistance of Klebsiella pneumoniae)
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11 pages, 2466 KiB  
Article
Prevalence of blaKPC-2, blaKPC-3 and blaKPC-30—Carrying Plasmids in Klebsiella pneumoniae Isolated in a Brazilian Hospital
by Letícia B. Migliorini, Romário O. de Sales, Paula C. M. Koga, Andre M. Doi, Anja Poehlein, Alexandra R. Toniolo, Fernando G. Menezes, Marines D. V. Martino, Ana C. Gales, Holger Brüggemann and Patricia Severino
Pathogens 2021, 10(3), 332; https://doi.org/10.3390/pathogens10030332 - 12 Mar 2021
Cited by 11 | Viewed by 3141
Abstract
Klebsiella pneumoniae carbapenemase (KPC) actively hydrolyzes carbapenems, antibiotics often used a last-line treatment for multidrug-resistant bacteria. KPC clinical relevance resides in its widespread dissemination. In this work, we report the genomic context of KPC coding genes blaKPC-2, blaKPC-3 and bla [...] Read more.
Klebsiella pneumoniae carbapenemase (KPC) actively hydrolyzes carbapenems, antibiotics often used a last-line treatment for multidrug-resistant bacteria. KPC clinical relevance resides in its widespread dissemination. In this work, we report the genomic context of KPC coding genes blaKPC-2, blaKPC-3 and blaKPC-30 in multidrug-resistant Klebsiellapneumoniae isolates from Brazil. Plasmids harboring blaKPC-3 and blaKPC-30 were identified. Fifteen additional carbapenem-resistant K. pneumoniae isolates were selected from the same tertiary hospital, collected over a period of 8 years. Their genomes were sequenced in order to evaluate the prevalence and dissemination of blaKPC–harboring plasmids. We found that blaKPC genes were mostly carried by one of two isoforms of transposon Tn4401 (Tn4401a or Tn4401b) that were predominantly located on plasmids highly similar to the previously described plasmid pKPC_FCF3SP (IncN). The identified pKPC_FCF3SP-like plasmids carried either blaKPC-2 or blaKPC-30. Two K. pneumoniae isolates harbored pKpQIL-like (IncFII) plasmids, only recently identified in Brazil; one of them harbored blaKPC-3 in a Tn4401a transposon. Underlining the risk of horizontal spread of KPC coding genes, this study reports the prevalence of blaKPC-2 and the recent spread of blaKPC-3, and blaKPC-30, in association with different isoforms of Tn4401, together with high synteny of plasmid backbones among isolates studied here and in comparison with previous reports. Full article
(This article belongs to the Special Issue Infection and Antimicrobial Resistance of Klebsiella pneumoniae)
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6 pages, 609 KiB  
Case Report
Source Identification of Klebsiella pneumoniae Causing Six Episodes of Recurrent Sepsis in an Adolescent That Underwent Hematopoietic Stem Cell Transplantation
by Suejung Jo, Hyun Mi Kang, Seong Koo Kim, Jae Wook Lee, Nack-Gyun Chung, Bin Cho, Dae Chul Jeong and Yeon-Joon Park
Pathogens 2021, 10(9), 1123; https://doi.org/10.3390/pathogens10091123 - 2 Sep 2021
Cited by 1 | Viewed by 2176
Abstract
Septicemia or bacteremia is one of the leading causes of death worldwide. Long-term tunneled central venous catheters (CVCs) are usually placed in children undergoing chemotherapy or hematopoietic stem cell transplantation (HSCT) for underlying hemato–oncologic malignancies. However, catheter-related complications have been reported frequently, and [...] Read more.
Septicemia or bacteremia is one of the leading causes of death worldwide. Long-term tunneled central venous catheters (CVCs) are usually placed in children undergoing chemotherapy or hematopoietic stem cell transplantation (HSCT) for underlying hemato–oncologic malignancies. However, catheter-related complications have been reported frequently, and there is high morbidity and mortality related to catheter-line-associated bloodstream infections (CLABSIs). We report a rare case of six episodes of recurrent K. pneumoniae sepsis within a 6-month period in a 12-year-old male adolescent that underwent HSCT for acute lymphoblastic leukemia, despite treatment with susceptible antibiotics. The patient received extensive diagnostic evaluations to find the hidden source; however, failure to discover the primary source led to multiple recurrences. Through enterobacterial repetitive intergenic consensus (ERIC)-PCR, we were able to identify the relationship between the six episodes and recognize the source of bacteremia. Full article
(This article belongs to the Special Issue Infection and Antimicrobial Resistance of Klebsiella pneumoniae)
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