Genomic dissection of Klebsiella pneumoniae infections in hospital patients reveals insights into an opportunistic pathogen.
Genomic dissection of Klebsiella pneumoniae infections in hospital patients reveals insights into an opportunistic pathogen.
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DOI：
10.1038/s41467-022-30717-6
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发表时间：
2022-05-31
影响因子：
16.6
通讯作者：
中科院分区：
文献类型：
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作者：
肺炎克雷伯菌是机会性医疗保健相关感染的主要原因，由于超广谱β-内酰胺酶（ESBLs）和碳青霉烯耐药性的存在，这些感染日益复杂。我们对K.肺炎临床分离株。全基因组序列（WGS）数据揭示了一个多样化的病原体群体，包括其他物种内的K。肺炎菌种复合体（18%）。几种感染是由K. variicola/克氏隐球菌pneumoniae hybrids，其中之一显示出医院传播的证据。观察到广泛的抗菌素耐药性（AMR）表型，并确定了不同的遗传机制（主要是质粒携带的基因）。ESBLs与其他获得性AMR基因的存在相关（中位数n = 10）。与医院内发病相关的细菌基因组特征是ESBLs（OR 2.34，p = 0.015）和鼠李糖阳性荚膜（OR 3.12，p < 0.001）。毒力质粒编码特征（需氧菌素、高粘体）在低流行率（<3%）下观察到，主要发生在社区发病病例中。WGS证实的院内传播仅涉及10%的病例，但与ESBLs密切相关（OR 21，p < 1 × 10−11）。我们估计ESBL阳性菌株的院内传播风险为28%，而ESBL阴性菌株为1.7%。这些数据表明K.住院患者中的肺炎感染主要是由于不同菌株的机会性感染，以及医院传播的AMR菌株和社区获得性高毒力菌株的额外负担。肺炎克雷伯氏菌是一种机会致病菌，由于其耐药性的普遍存在，引起了越来越多的公共卫生关注。在这里，作者提供了深入了解耐药谱，细菌基因组特征和毒力基因，在一个为期一年的前瞻性研究K。肺炎临床分离株。
Klebsiella pneumoniae is a major cause of opportunistic healthcare-associated infections, which are increasingly complicated by the presence of extended-spectrum beta-lactamases (ESBLs) and carbapenem resistance. We conducted a year-long prospective surveillance study of K. pneumoniae clinical isolates in hospital patients. Whole-genome sequence (WGS) data reveals a diverse pathogen population, including other species within the K. pneumoniae species complex (18%). Several infections were caused by K. variicola/K. pneumoniae hybrids, one of which shows evidence of nosocomial transmission. A wide range of antimicrobial resistance (AMR) phenotypes are observed, and diverse genetic mechanisms identified (mainly plasmid-borne genes). ESBLs are correlated with presence of other acquired AMR genes (median n = 10). Bacterial genomic features associated with nosocomial onset are ESBLs (OR 2.34, p = 0.015) and rhamnose-positive capsules (OR 3.12, p < 0.001). Virulence plasmid-encoded features (aerobactin, hypermucoidy) are observed at low-prevalence (<3%), mostly in community-onset cases. WGS-confirmed nosocomial transmission is implicated in just 10% of cases, but strongly associated with ESBLs (OR 21, p < 1 × 10−11). We estimate 28% risk of onward nosocomial transmission for ESBL-positive strains vs 1.7% for ESBL-negative strains. These data indicate that K. pneumoniae infections in hospitalised patients are due largely to opportunistic infections with diverse strains, with an additional burden from nosocomially-transmitted AMR strains and community-acquired hypervirulent strains. Klebsiella pneumoniae is an opportunistic pathogen of increasing public health concern due to the prevalence of antimicrobial resistance. Here, the authors provide insight into the resistance profiles, bacterial genome features and virulence genes, in a year-long prospective study of K. pneumoniae clinical isolates.
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影响因子：
12.3
作者：
Cuénod A;Wüthrich D;Seth-Smith HMB;Ott C;Gehringer C;Foucault F;Mouchet R;Kassim A;Revathi G;Vogt DR;von Felten S;Bassetti S;Tschudin-Sutter S;Hettich T;Schlotterbeck G;Homberger C;Casanova C;Moran-Gilad J;Sagi O;Rodríguez-Sánchez B;Müller F;Aerni M;Gaia V;van Dessel H;Kampinga GA;Müller C;Daubenberger C;Pflüger V;Egli A
通讯作者：
Egli A
DOI：
10.1093/cid/ciy027
发表时间：
2018-07-02
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Gorrie CL;Mirceta M;Wick RR;Judd LM;Wyres KL;Thomson NR;Strugnell RA;Pratt NF;Garlick JS;Watson KM;Hunter PC;McGloughlin SA;Spelman DW;Jenney AWJ;Holt KE
通讯作者：
Holt KE
DOI：
10.1093/cid/cix270
发表时间：
2017-07-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Gorrie CL;Mirceta M;Wick RR;Edwards DJ;Thomson NR;Strugnell RA;Pratt NF;Garlick JS;Watson KM;Pilcher DV;McGloughlin SA;Spelman DW;Jenney AWJ;Holt KE
通讯作者：
Holt KE
影响因子：
3.9
作者：
Constantinides, Bede;Chau, Kevin K.;Stoesser, Nicole
通讯作者：
Stoesser, Nicole
过度抗呼吸和多药的肺炎克隆基团的基因组定义。
影响因子：
11.8
作者：
Bialek-Davenet S;Criscuolo A;Ailloud F;Passet V;Jones L;Delannoy-Vieillard AS;Garin B;Le Hello S;Arlet G;Nicolas-Chanoine MH;Decré D;Brisse S
通讯作者：
Brisse S