Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore

The convergence of carbapenem-resistance and hypervirulence genes in Klebsiella pneumoniae has led to the emergence of highly drug-resistant superbugs capable of causing invasive disease. We analyzed 556 carbapenem-resistant K. pneumoniae isolates from patients in Singapore hospitals during 2010-201...

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Main Authors: Chen, Yahua, Marimuthu, Kalisvar, Teo, Jeanette, Venkatachalam, Indumathi, Cherng, Benjamin Pei Zhi, Wang, Liang De, Prakki, Sai Rama Sridatta, Xu, Weizhen, Tan, Yi Han, Nguyen, Lan Chi, Koh, Tse Hsien, Ng, Oon Tek, Gan, Yunn-Hwen
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2020
Subjects:
K1
Online Access:https://hdl.handle.net/10356/145330
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Institution: Nanyang Technological University
Language: English
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spelling sg-ntu-dr.10356-1453302023-03-05T16:49:14Z Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore Chen, Yahua Marimuthu, Kalisvar Teo, Jeanette Venkatachalam, Indumathi Cherng, Benjamin Pei Zhi Wang, Liang De Prakki, Sai Rama Sridatta Xu, Weizhen Tan, Yi Han Nguyen, Lan Chi Koh, Tse Hsien Ng, Oon Tek Gan, Yunn-Hwen Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Enterobacteriaceae K1 The convergence of carbapenem-resistance and hypervirulence genes in Klebsiella pneumoniae has led to the emergence of highly drug-resistant superbugs capable of causing invasive disease. We analyzed 556 carbapenem-resistant K. pneumoniae isolates from patients in Singapore hospitals during 2010-2015 and discovered 18 isolates from 7 patients also harbored hypervirulence features. All isolates contained a closely related plasmid (pKPC2) harboring blaKPC-2, a K. pneumoniae carbapenemase gene, and had a hypervirulent background of capsular serotypes K1, K2, and K20. In total, 5 of 7 first patient isolates were hypermucoviscous, and 6 were virulent in mice. The pKPC2 was highly transmissible and remarkably stable, maintained in bacteria within a patient with few changes for months in the absence of antimicrobial drug selection pressure. Intrapatient isolates were also able to acquire additional antimicrobial drug resistance genes when inside human bodies. Our results highlight the potential spread of carbapenem-resistant hypervirulent K. pneumoniae in Singapore. National Medical Research Council (NMRC) Published version This work was supported by the National University of Singapore, Yong Loo Lin School of Medicine Aspiration Fund (NUHSRO/2014/068/AF New Idea/03), and National Medical Research Council (NMRC) collaborative grant Collaborative Solutions Targeting Antimicrobial Resistance Threats in Health Systems (CoSTAR-HS, HS/ARGSeedGrant/2017/03) to Y.-H.G. Additional grant support was provided by CoSTAR-HS (NMRC CGAug16C005), NMRC Clinician Scientist Award (NMRC/CSA-INV/0007/2016), and NMRC Clinician Scientist Award (MOH-000276). 2020-12-17T06:41:03Z 2020-12-17T06:41:03Z 2020 Journal Article Chen, Y., Marimuthu, K., Teo, J., Venkatachalam, I., Cherng, B. P. Z., Wang, L. D., . . . Gan, Y.-H. (2020). Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore. Emerging Infectious Diseases, 26(3), 549-559. doi:10.3201/eid2603.191230 1080-6040 https://hdl.handle.net/10356/145330 10.3201/eid2603.191230 32091354 3 26 549 559 en CoSTAR-HS, HS/ARGSeedGrant/2017/03 NMRC CGAug16C005 NMRC/CSA-INV/0007/2016 MOH-000276 Emerging Infectious Diseases © 2020 The Author(s) (published by Public Domain). This is an open-access article distributed under the terms of the Creative Commons Attribution License. application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Science::Medicine
Enterobacteriaceae
K1
spellingShingle Science::Medicine
Enterobacteriaceae
K1
Chen, Yahua
Marimuthu, Kalisvar
Teo, Jeanette
Venkatachalam, Indumathi
Cherng, Benjamin Pei Zhi
Wang, Liang De
Prakki, Sai Rama Sridatta
Xu, Weizhen
Tan, Yi Han
Nguyen, Lan Chi
Koh, Tse Hsien
Ng, Oon Tek
Gan, Yunn-Hwen
Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore
description The convergence of carbapenem-resistance and hypervirulence genes in Klebsiella pneumoniae has led to the emergence of highly drug-resistant superbugs capable of causing invasive disease. We analyzed 556 carbapenem-resistant K. pneumoniae isolates from patients in Singapore hospitals during 2010-2015 and discovered 18 isolates from 7 patients also harbored hypervirulence features. All isolates contained a closely related plasmid (pKPC2) harboring blaKPC-2, a K. pneumoniae carbapenemase gene, and had a hypervirulent background of capsular serotypes K1, K2, and K20. In total, 5 of 7 first patient isolates were hypermucoviscous, and 6 were virulent in mice. The pKPC2 was highly transmissible and remarkably stable, maintained in bacteria within a patient with few changes for months in the absence of antimicrobial drug selection pressure. Intrapatient isolates were also able to acquire additional antimicrobial drug resistance genes when inside human bodies. Our results highlight the potential spread of carbapenem-resistant hypervirulent K. pneumoniae in Singapore.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Chen, Yahua
Marimuthu, Kalisvar
Teo, Jeanette
Venkatachalam, Indumathi
Cherng, Benjamin Pei Zhi
Wang, Liang De
Prakki, Sai Rama Sridatta
Xu, Weizhen
Tan, Yi Han
Nguyen, Lan Chi
Koh, Tse Hsien
Ng, Oon Tek
Gan, Yunn-Hwen
format Article
author Chen, Yahua
Marimuthu, Kalisvar
Teo, Jeanette
Venkatachalam, Indumathi
Cherng, Benjamin Pei Zhi
Wang, Liang De
Prakki, Sai Rama Sridatta
Xu, Weizhen
Tan, Yi Han
Nguyen, Lan Chi
Koh, Tse Hsien
Ng, Oon Tek
Gan, Yunn-Hwen
author_sort Chen, Yahua
title Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore
title_short Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore
title_full Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore
title_fullStr Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore
title_full_unstemmed Acquisition of plasmid with carbapenem-resistance gene blaKPC2 in hypervirulent Klebsiella pneumoniae, Singapore
title_sort acquisition of plasmid with carbapenem-resistance gene blakpc2 in hypervirulent klebsiella pneumoniae, singapore
publishDate 2020
url https://hdl.handle.net/10356/145330
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