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Shrestha, Raj Kumar, Shrestha, Dhruba, Kunwar, Ajaya Jang, Thapa, Sandeep, Shrestha, Nipun, Dhoubhadel, Bhim Gopal and Parry, Christopher (2024) 'The overlap of accessory virulence factors and multidrug resistance among clinical and surveillance Klebsiella pneumoniae isolates from a neonatal intensive care unit in Nepal: a single-centre experience in a resource-limited setting'. Tropical Medicine and Health, Vol 52, Issue 1, e30.
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Abstract
Background: There is a lack of data on the characteristics of overlap between acquired antimicrobial resistance and virulence factors in Klebsiella pneumoniae in high-risk settings, especially with the inclusion of surveillance isolates along with the clinical. We investigated K. pneumoniae isolates, from a neonatal intensive care unit (NICU) in Nepal, for the presence of both accessory virulence factors and acquired antimicrobial resistance.
Methods: Thirty-eight clinical and nineteen surveillance K. pneumoniae isolates obtained between January 2017 and August 2022 in the NICU of Siddhi Memorial Hospital, Bhaktapur, Nepal were investigated with antimicrobial susceptibility testing, PCR-based detection of β-lactamases and virulence factors, and genetic similarity by ERIC–PCR.
Results: K. pneumoniae was found positive in 37/85 (43.5%) blood culture-positive neonatal bloodstream infections, 34/954 (3.6%) patient surveillance cultures, and 15/451 (3.3%) environmental surveillance samples. Among 57 isolates analyzed in this study, we detected multidrug resistance in 37/57 (64.9%), which was combined with at least one accessory virulence factor in 21/37 (56.8%). This overlap was mostly among β-lactamase producing isolates with accessory mechanisms of iron acquisition. These isolates displayed heterogenous ERIC–PCR patterns suggesting genetic diversity.
Conclusions: The clinical significance of this overlap between acquired antimicrobial resistance and accessory virulence genes in K. pneumoniae needs further investigation. Better resource allocation is necessary to strengthen infection prevention and control interventions in resource-limited settings.
| Item Type: | Article |
|---|---|
| Subjects: | QW Microbiology and Immunology > QW 45 Microbial drug resistance. General or not elsewhere classified. WA Public Health > WA 19 Schools, colleges, and specialized departments and facilities WA Public Health > WA 30 Socioeconomic factors in public health (General) WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department Education |
| Digital Object Identifer (DOI): | https://doi.org/10.1186/s41182-024-00595-3 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 18 Apr 2024 13:23 |
| Last Modified: | 18 Apr 2024 13:23 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/24362 |
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