Molecular Characterization of Resistance and Virulence Genes, and Detection of Heteroresistance in Klebsiella aerogenes Strains Isolated from Patients in the Intensive Care Unit

• Grant number: 23/08917-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2023
• End date: September 30, 2024
• Field of knowledge: Biological Sciences - Genetics - Molecular Genetics and Genetics of Microorganisms
• Principal Investigator: Maria Cristina da Silva Pranchevicius
• Grantee: Gustavo Dantas Nunes
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

The emergence of Enterobacteriaceae resistant to carbapenem antibiotics (CRE) represents one of the most serious public health challenges in the world. Currently, antibiotic options for the treatment of CRE are very limited, with tigecycline and colistin being the last two treatment options. However, tigecycline resistance and colistin heteroresistance are also rapidly increasing. Klebsiella aerogenes, formerly described as Enterobacter aerogenes, is an opportunistic pathogen associated with a variety of nosocomial infections, including sepsis, pneumonia, and urinary tract infection. Carbapenem-resistant Klebsiella aerogenes (CRKA) pose a serious threat to clinical therapy and the main resistance mechanism of CRE is the production of carbapenamases, followed by other mechanisms such as overproduction of ²-lactamases, efflux pumps, porin deficiency and alterations in penicillin-binding proteins. The aim of this study is to investigate the antibiotic resistance profile, characterize the resistance and virulence genes and the clonal relationships between carbapenem-resistant K. aerogenes strains isolated from patients in the Intensive Care Unit. In addition, we intend to identify heteroresistance to the antibiotics colistin and/or tigecycline in CRKA isolates, and verify whether the combination of colistin and tigecycline can be a treatment strategy for patients infected with heteroresistant CRKA.