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2020-12-09Zeitschriftenartikel DOI: 10.1186/s13073-020-00814-6
A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition
dc.contributor.authorHeiden, Stefan E.
dc.contributor.authorHübner, Nils-Olaf
dc.contributor.authorBohnert, Jürgen A.
dc.contributor.authorHeidecke, Claus-Dieter
dc.contributor.authorKramer, Axel
dc.contributor.authorBalau, Veronika
dc.contributor.authorGierer, Wolfgang
dc.contributor.authorSchaefer, Stephan
dc.contributor.authorEckmanns, Tim
dc.contributor.authorGatermann, Sören
dc.contributor.authorEger, Elias
dc.contributor.authorGuenther, Sebastian
dc.contributor.authorBecker, Karsten
dc.contributor.authorSchaufler, Katharina
dc.date.accessioned2021-02-01T17:05:17Z
dc.date.available2021-02-01T17:05:17Z
dc.date.issued2020-12-09none
dc.identifier.other10.1186/s13073-020-00814-6
dc.identifier.urihttp://edoc.rki.de/176904/7729
dc.description.abstractBackground 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.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectXDR Klebsiella pneumoniaeeng
dc.subjectOutbreakeng
dc.subjectHypervirulenceeng
dc.subjectPlasmid transmissioneng
dc.subject“Mosaic” plasmideng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleA Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisitionnone
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:0257-176904/7729-9
dc.identifier.doihttps://doi.org/10.1186/s13073-020-00814-6
dc.identifier.doihttp://dx.doi.org/10.25646/7948
dc.type.versionpublishedVersionnone
local.edoc.container-titleGenome Medicinenone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://genomemedicine.biomedcentral.com/articles/10.1186/s13073-020-00814-6none
local.edoc.container-publisher-nameBMC
local.edoc.container-volume12none
local.edoc.container-issue113none
local.edoc.container-reportyear2020
local.edoc.container-firstpage1none
local.edoc.container-lastpage15none
local.edoc.rki-departmentInfektionsepidemiologienone
dc.description.versionPeer Reviewednone

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