An unequivocal superbug: PDR Klebsiella pneumoniae with an arsenal of resistance and virulence factor genes

  • Ahmad Sleiman Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
  • Bassel Awada Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
  • Michele Mocadie Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  • Nour Sherri Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
  • Louis-Patrick Haraoui Department of Microbiology and Infectious Diseases, University of Sherbrooke, Sherbrooke, QC, Canada
  • Vincent Baby Department of Microbiology and Infectious Diseases, University of Sherbrooke, Sherbrooke, QC, Canada
  • George F Araj Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
  • Souha S Kanj Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
  • Nesrine Rizk Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
  • Ghassan M Matar Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
  • Antoine G Abou Fayad Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
Keywords: K. pneumoniae, XDR, PDR, AMR, NDM, OXA

Abstract

Introduction: Infections caused by extensively-drug resistant (XDR) and pan-drug resistant (PDR) Klebsiella pneumoniae represent an emerging threat due to the high associated mortality. This study aimed to characterize two carbapenem resistant K. pneumoniae strains from the same patient, the first being PDR (referred to as IMP 1078b) and the second being XDR (referred to IMP 1078s) isolated from the same patient.

Methodology: Antimicrobial susceptibility testing was done for the 2 K. pneumoniae isolates, followed by carbapenem/β-lactamase inhibitor combination assay, and fitness cost against cefepime and meropenem. Then, whole-genome sequence analysis was performed to decipher the molecular mechanisms behind the high level of resistance recorded in both isolates. Finally, qRT-PCR was done for β-lactam resistant genes.

Results: This is the first report about a K. pneumoniae isolate harboring 47 antimicrobial resistance genes and having type IV pilli (Yersinia) and the fimbrial adherence determinant Stb (Salmonella) as virulence factors. Further analysis on both isolates are discussed within the article.

Conclusion: The co-existence of a high number of antimicrobial resistant (AMR) genes and virulence factor genes may lead to a life threatening invasive and untreatable infection.

Published
2021-03-31
How to Cite
1.
Sleiman A, Awada B, Mocadie M, Sherri N, Haraoui L-P, Baby V, Araj GF, Kanj SS, Rizk N, Matar GM, Abou Fayad AG (2021) An unequivocal superbug: PDR Klebsiella pneumoniae with an arsenal of resistance and virulence factor genes . J Infect Dev Ctries 15:404-414. doi: 10.3855/jidc.13573
Section
Original Articles