A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition
Abstract Background Antibiotic-resistant Klebsiella pneumoniae are a major cause of hospital- and community-acquired infections, including sepsis, liver abscess, and pneumonia, driven mainly by the emergence of successful high-risk clonal lineages. The K. pneumoniae sequence type (ST) 307 lineage ha...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-12-01
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| Series: | Genome Medicine |
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| Online Access: | https://doi.org/10.1186/s13073-020-00814-6 |
| _version_ | 1818929306103971840 |
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| author | Stefan E. Heiden Nils-Olaf Hübner Jürgen A. Bohnert Claus-Dieter Heidecke Axel Kramer Veronika Balau Wolfgang Gierer Stephan Schaefer Tim Eckmanns Sören Gatermann Elias Eger Sebastian Guenther Karsten Becker Katharina Schaufler |
| author_facet | Stefan E. Heiden Nils-Olaf Hübner Jürgen A. Bohnert Claus-Dieter Heidecke Axel Kramer Veronika Balau Wolfgang Gierer Stephan Schaefer Tim Eckmanns Sören Gatermann Elias Eger Sebastian Guenther Karsten Becker Katharina Schaufler |
| author_sort | Stefan E. Heiden |
| collection | DOAJ |
| description | Abstract Background Antibiotic-resistant Klebsiella pneumoniae are a major cause of hospital- and community-acquired infections, including sepsis, liver abscess, and pneumonia, driven mainly by the emergence of successful high-risk clonal lineages. The K. pneumoniae sequence type (ST) 307 lineage has appeared in several different parts of the world after first being described in Europe in 2008. From June to October 2019, we recorded an outbreak of an extensively drug-resistant ST307 lineage in four medical facilities in north-eastern Germany. Methods Here, we investigated these isolates and those from subsequent cases in the same facilities. We performed whole-genome sequencing to study phylogenetics, microevolution, and plasmid transmission, as well as phenotypic experiments including growth curves, hypermucoviscosity, siderophore secretion, biofilm formation, desiccation resilience, serum survival, and heavy metal resistance for an in-depth characterization of this outbreak clone. Results Phylogenetics suggest a homogenous phylogram with several sub-clades containing either isolates from only one patient or isolates originating from different patients, suggesting inter-patient transmission. We identified three large resistance plasmids, carrying either NDM-1, CTX-M-15, or OXA-48, which K. pneumoniae ST307 likely donated to other K. pneumoniae isolates of different STs and even other bacterial species (e.g., Enterobacter cloacae) within the clinical settings. Several chromosomally and plasmid-encoded, hypervirulence-associated virulence factors (e.g., yersiniabactin, metabolite transporter, aerobactin, and heavy metal resistance genes) were identified in addition. While growth, biofilm formation, desiccation resilience, serum survival, and heavy metal resistance were comparable to several control strains, results from siderophore secretion and hypermucoviscosity experiments revealed superiority of the ST307 clone, similar to an archetypical, hypervirulent K. pneumoniae strain (hvKP1). Conclusions The combination of extensive drug resistance and virulence, partly conferred through a “mosaic” plasmid carrying both antibiotic resistance and hypervirulence-associated features, demonstrates serious public health implications. |
| first_indexed | 2024-12-20T03:42:42Z |
| format | Article |
| id | doaj.art-8e481b0612b54ca6b9da3ff8fc5d0133 |
| institution | Directory Open Access Journal |
| issn | 1756-994X |
| language | English |
| last_indexed | 2024-12-20T03:42:42Z |
| publishDate | 2020-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Genome Medicine |
| spelling | doaj.art-8e481b0612b54ca6b9da3ff8fc5d01332022-12-21T19:54:43ZengBMCGenome Medicine1756-994X2020-12-0112111510.1186/s13073-020-00814-6A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisitionStefan E. Heiden0Nils-Olaf Hübner1Jürgen A. Bohnert2Claus-Dieter Heidecke3Axel Kramer4Veronika Balau5Wolfgang Gierer6Stephan Schaefer7Tim Eckmanns8Sören Gatermann9Elias Eger10Sebastian Guenther11Karsten Becker12Katharina Schaufler13Institute of Pharmacy, Pharmaceutical Microbiology, University of GreifswaldCentral Unit for Infection Prevention and Control, University Medicine GreifswaldFriedrich Loeffler-Institute of Medical Microbiology, University Medicine GreifswaldDepartment of General, Visceral, Thoracic and Vascular Surgery, University Medicine GreifswaldInstitute for Hygiene and Environmental Medicine, University Medicine GreifswaldIMD Laboratory Greifswald, Institute of Medical DiagnosticsMVZ Laboratory Limbach Vorpommern-RügenMVZ Laboratory Limbach Vorpommern-RügenDepartment for Infectious Disease Epidemiology, Robert Koch-InstituteNational Reference Centre for Multidrug-Resistant Gram-Negative Bacteria, Ruhr University BochumInstitute of Pharmacy, Pharmaceutical Microbiology, University of GreifswaldInstitute of Pharmacy, Pharmaceutical Biology, University of GreifswaldFriedrich Loeffler-Institute of Medical Microbiology, University Medicine GreifswaldInstitute of Pharmacy, Pharmaceutical Microbiology, University of GreifswaldAbstract Background Antibiotic-resistant Klebsiella pneumoniae are a major cause of hospital- and community-acquired infections, including sepsis, liver abscess, and pneumonia, driven mainly by the emergence of successful high-risk clonal lineages. The K. pneumoniae sequence type (ST) 307 lineage has appeared in several different parts of the world after first being described in Europe in 2008. From June to October 2019, we recorded an outbreak of an extensively drug-resistant ST307 lineage in four medical facilities in north-eastern Germany. Methods Here, we investigated these isolates and those from subsequent cases in the same facilities. We performed whole-genome sequencing to study phylogenetics, microevolution, and plasmid transmission, as well as phenotypic experiments including growth curves, hypermucoviscosity, siderophore secretion, biofilm formation, desiccation resilience, serum survival, and heavy metal resistance for an in-depth characterization of this outbreak clone. Results Phylogenetics suggest a homogenous phylogram with several sub-clades containing either isolates from only one patient or isolates originating from different patients, suggesting inter-patient transmission. We identified three large resistance plasmids, carrying either NDM-1, CTX-M-15, or OXA-48, which K. pneumoniae ST307 likely donated to other K. pneumoniae isolates of different STs and even other bacterial species (e.g., Enterobacter cloacae) within the clinical settings. Several chromosomally and plasmid-encoded, hypervirulence-associated virulence factors (e.g., yersiniabactin, metabolite transporter, aerobactin, and heavy metal resistance genes) were identified in addition. While growth, biofilm formation, desiccation resilience, serum survival, and heavy metal resistance were comparable to several control strains, results from siderophore secretion and hypermucoviscosity experiments revealed superiority of the ST307 clone, similar to an archetypical, hypervirulent K. pneumoniae strain (hvKP1). Conclusions The combination of extensive drug resistance and virulence, partly conferred through a “mosaic” plasmid carrying both antibiotic resistance and hypervirulence-associated features, demonstrates serious public health implications.https://doi.org/10.1186/s13073-020-00814-6XDR Klebsiella pneumoniaeOutbreakHypervirulencePlasmid transmission“Mosaic” plasmid |
| spellingShingle | Stefan E. Heiden Nils-Olaf Hübner Jürgen A. Bohnert Claus-Dieter Heidecke Axel Kramer Veronika Balau Wolfgang Gierer Stephan Schaefer Tim Eckmanns Sören Gatermann Elias Eger Sebastian Guenther Karsten Becker Katharina Schaufler A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition Genome Medicine XDR Klebsiella pneumoniae Outbreak Hypervirulence Plasmid transmission “Mosaic” plasmid |
| title | A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition |
| title_full | A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition |
| title_fullStr | A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition |
| title_full_unstemmed | A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition |
| title_short | A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition |
| title_sort | klebsiella pneumoniae st307 outbreak clone from germany demonstrates features of extensive drug resistance hypermucoviscosity and enhanced iron acquisition |
| topic | XDR Klebsiella pneumoniae Outbreak Hypervirulence Plasmid transmission “Mosaic” plasmid |
| url | https://doi.org/10.1186/s13073-020-00814-6 |
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