Long-term occurrence of multiple antimicrobial drug resistant Klebsiella pneumoniae isolates harboring virulent potential in a tertiary hospital from Brazil

• Published in: Brazilian journal of microbiology 2024-09, Vol.55 (3), p.2313-2320
• Main Authors: Cardoso Almeida, Ana Paula, de Moraes, Miguel Augusto, da Silva, Amanda Kamyla Ferreira, Oliveira-Silva, Mariana, Nakamura-Silva, Rafael, de Almeida, Felipe Marques, Pappas Junior, Georgios Joannis, Pitondo-Silva, André, de Campos, Tatiana Amabile
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - pharmacology; Antimicrobial agents; Antimicrobial resistance; Biomedical and Life Sciences; Brazil; Clinical Microbiology - Research Paper; Disease resistance; Drug resistance; Drug Resistance, Multiple, Bacterial - genetics; Food Microbiology; Gene frequency; Genes; Hospitals; Humans; Klebsiella; Klebsiella Infections - epidemiology; Klebsiella Infections - microbiology; Klebsiella pneumoniae; Klebsiella pneumoniae - classification; Klebsiella pneumoniae - drug effects; Klebsiella pneumoniae - genetics; Klebsiella pneumoniae - isolation & purification; Klebsiella pneumoniae - pathogenicity; Life Sciences; Medical Microbiology; Microbial Ecology; Microbial Genetics and Genomics; Microbial Sensitivity Tests; Microbiology; Multidrug resistance; Mycology; Phenotypes; Tertiary Care Centers - statistics & numerical data; Virulence; Virulence - genetics; Virulence Factors - genetics
• ISSN: 1517-8382; 1678-4405; 1678-4405
• DOI: 10.1007/s42770-024-01358-2

Klebsiella pneumoniae strains are globally associated with a plethora of opportunistic and severe human infections and are known to spread genes conferring antimicrobial resistance. Some strains harbor virulence determinants that enable them to cause serious disease in any patient, both in the hospital and in the community. The aim of this study was to determine the frequency of antimicrobial resistance and virulence traits (by gene detection and string test) among 83 K . pneumoniae isolates obtained from patient cultures of a scholar tertiary hospital in the Midwestern Brazil (Brasília, DF). Antimicrobial susceptibility analysis showed that 94% (78/83) of the isolates presented one of the following resistance profiles: resistant (R, 39), multidrug-resistant (MDR, 29), or extensively drug-resistant (XDR, 10). Several MDR and XDR strains harbored multiple virulence genes and displayed hypermucoviscous phenotype. These characteristics were observed among isolates obtained throughout all the sample collection period (2013 – 2017). The K2 serotype gene, a molecular marker of hypervirulence, was detected in three isolates, one of which classified as XDR. Sequence typing revealed the occurrence of isolates belonged to high-risk (ST13) and multiple resistance-spreading clones (ST105). Thus, our findings showed the occurrence of virulent potential isolates that also presented MDR/XDR phenotypes from 2013 to 2015. This study also indicates the probable convergence of virulence and resistance since at least 2013 in Brazil.