Abstract:
This study aimed to screen antibiotic resistance and virulence genes in carbapenemresistant hypermucoviscous Klebsiella pneumoniae isolates from an Egyptian hospital.
Among 38 previously confirmed carbapenem-nonsusceptible K. pneumoniae isolates,
a string test identified three isolates as positive for hypermucoviscosity. Phenotypic
characterization and molecular detection of carbapenemase- and virulence-encoding
genes were performed. PCR-based multilocus sequence typing and phylogenetics were
used to determine the clonality and global epidemiology of the strains. The coexistence
of virulence and resistance genes in the isolates was analyzed statistically using a chisquare test. Three isolates showed the presence of carbapenemase-encoding genes
(blaNDM, blaVIM, and blaIMP), adhesion genes (fim-H-1 and mrkD), and siderophore genes
(entB); the isolates belonged to sequence types (STs) 101, 1310, and 1626. The relatedness between these sequence types and the sequence types of globally detected
hypermucoviscous K. pneumoniae that also harbor carbapenemases was determined.
Our analysis showed that the resistance and virulence profiles were not homogenous.
Phylogenetically, different clones clustered together. There was no significant association between the presence of resistance and virulence genes in the isolates. There
is a need for periodic surveillance of the healthcare settings in Egypt and globally
to understand the true epidemiology of carbapenem-resistant, hypermucoviscous K.
pneumoniae.
Description:
SUPPLEMENTARY MATERIAL : FIGURE S1A. Multiple sequence alignment of nucleotides and translated nucleotides of gapA genes of the three isolates.
FIGURE S1B. Multiple sequence alignment of nucleotides and translated nucleotides of infB genes of the three isolates.
FIGURE S1C. Multiple sequence alignment of nucleotides and translated nucleotides of mdh genes of the three isolates.
FIGURE S1D. Multiple sequence alignment of nucleotides and translated nucleotides of pgi genes of the three isolates.
FIGURE S1E. Multiple sequence alignment of nucleotides and translated nucleotides of phoE genes of the three isolates.
FIGURE S1F. Multiple sequence alignment of nucleotides and translated nucleotides of rpoB genes of the three isolates.
FIGURE S1G. Multiple sequence alignment of nucleotides and translated nucleotides of tonB genes of the three isolates.
TABLE S1. Primer sequences and their expected amplicon sizes.
TABLE S2. TABLE S3. TABLE S4. Count of the various virulence genes identified in the hypermucoviscous carbapenem-resistant K. pneumoniae isolates in the other investigated studies (Argentina, China, and India). TABLE S5. The detected mutations among the housekeeping genes of the investigated isolates.
