Expansion of healthcare-associated hypervirulent KPC-2-producing Klebsiella pneumoniae ST11/KL64 beyond hospital settings

Author(s):Show less -

Esposito, Fernanda ; Cardoso, Brenda ; Sellera, Fabio P. ; Sano, Elder ; Fuentes-Castillo, Danny ; Fontana, Herrison ; Fuga, Bruna ; Moura, Quezia ; Sato, Maria I. Z. ; Brandao, Carlos J. ; Lincopan, Nilton

• Document type: Journal article
• Source: ONE HEALTH; v. 17, p. 6-pg., 2023-12-01.

Abstract

The spread of carbapenemase-producing Klebsiella pneumoniae beyond hospital settings is a global critical issue within a public health and One Health perspective. Another worrisome concern is the convergence of virulence and resistance in healthcare-associated lineages of K. pneumoniae leading to unfavorable clinical outcomes. During a surveillance study of WHO critical priority pathogens circulating in an impacted urban river in Sa & SIM;o Paulo, Brazil, we isolate two hypermucoviscous and multidrug-resistant K. pneumoniae strains (PINH-4250 and PINH-4900) from two different locations near to medical centers. Genomic investigation revealed that both strains belonged to the global high-risk sequence type (ST) ST11, carrying the blaKPC-2 carbapenemase gene, besides other medically important antimicrobial resistance determinants. A broad virulome was predicted and associated with hypervirulent behavior in the Galleria mellonella infection model. Comparative phylogenomic analysis of PINH-4250 and PINH-4900 along to an international collection of publicly available genomes of K. pneumoniae ST11 revealed that both environmental strains were closely related to hospital-associated K. pneumoniae strains recovered from clinical samples between 2006 and 2018, in Sa & SIM;o Paulo city. Our find-ings support that healthcare-associated KPC-2-positive K. pneumoniae of ST11 clone has successfully expanded beyond hospital settings. In summary, aquatic environments can become potential sources of international clones of K. pneumoniae displaying carbapenem resistance and hypervirulent behaviors, which is a critical issue within a One Health perspective. (AU)

• FAPESP's process: 19/15578-4 - Virulome and pathogenicity of carbapenem- and polymyxin-resistant priority pathogens
• Grantee: Fernanda Ribeiro dos Santos Esposito
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 20/08224-9 - OneBR (One Health Brazilian Resistance): integrated genomic database for surveillance, diagnosis, management and treatment of antimicrobial resistance in the human-animal-environment interface, in Brazil
• Grantee: Nilton Erbet Lincopan Huenuman
• Support Opportunities: Regular Research Grants