A Fatal Bacteremia Caused by Hypermucousviscous KPC-2 Producing Extensively Drug-Resistant K64-ST11 Klebsiella pneumoniae in Brazil
A Fatal Bacteremia Caused by Hypermucousviscous KPC-2 Producing Extensively Drug-Resistant K64-ST11 Klebsiella pneumoniae in Brazil
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DOI：
10.3389/fmed.2018.00265
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发表时间：
2018-09-21
影响因子：
3.9
通讯作者：
Pitondo-Silva, Andre
中科院分区：
文献类型：
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作者：
de Campos, Tatiana Amabile;Goncalves, Laura Fernandes;Pitondo-Silva, Andre
我们报告了一名来自巴西的 60-70 岁患者出现由肺炎克雷伯菌引起的致命菌血症。对三种分离株（来自血培养物、鼻腔和肛门拭子）的基因组分析表明，菌血症是由 KPC-2 引起的，该 KPC-2 产生广泛耐药的 K64-ST11 高粘液性肺炎克雷伯菌 (hmKP)，其中含有多种毒力和抗菌素耐药基因。尽管分离株不存在与高毒力肺炎克雷伯菌 (hvKP) 相关的毒力标记，但它们表现出对上皮 Hep-2 细胞的侵袭和毒性；对细胞杀菌机制的抵抗力；以及血液和人血清的存活率，证明了它们的致病潜力。这项研究强调了未定性为 hvKP 的 hmKp 菌株引起的感染风险以及临床意义和治疗难度，特别是在老年或免疫功能低下的患者中。
We report a fatal bacteremia caused by Klebsiella pneumoniae in a 60-70-year-old patient from Brazil. The genomic analysis of three isolates (from blood culture, nasal and anal swabs) showed that the bacteremia was caused by a KPC-2 producing extensively drug-resistant K64-ST11 hypermucousviscous K. pneumoniae (hmKP) harboring several virulence and antimicrobial resistance genes. Although the isolates did not present virulence markers associated with hypervirulent K. pneumoniae (hvKP), they showed invasion and toxicity to epithelial Hep-2 cells; resistance to cell microbicidal mechanisms; and blood and human serum survival, evidencing their pathogenic potential. This study highlights the risk of infection caused by hmKp strains not characterized as hvKP as well as the clinical implications and difficulty of treatment, especially in elderly or immunocompromised patients.