| Author | Gomes, Marisa Zenaide Ribeiro | |
| Author | Lima, Elisangela Martins de | |
| Author | Aires, Caio Augusto Martins | |
| Author | Pereira, Polyana Silva | |
| Author | Yim, Juwon | |
| Author | Silva, Fernando Henrique | |
| Author | Rodrigues, Caio Augusto Santos | |
| Author | Oliveira, Thamirys Rachel Tavares e | |
| Author | Silva, Priscila Pinho da | |
| Author | Eller, Cristiane Monteiro | |
| Author | Souza, Claudio Marcos Rocha de | |
| Author | Rybak, Michael J. | |
| Author | Albano, Rodolpho Mattos | |
| Author | Miranda, Antonio Basílio de | |
| Author | Machado, Edson | |
| Author | Catanho, Marcos | |
| Author | Nucleus of Hospital Research (NPH) study collaborators * | |
| Access date | 2023-04-26T20:34:44Z | |
| Available date | 2023-04-26T20:34:44Z | |
| Document date | 2023 | |
| Citation | GOMES, Marisa Zenaide Ribeiro et al. Outbreak report of p oly myx incar bap ene m‑r esistant Klebsiella pneumoniae causing untreatable infections evidenced by synergy tests and bacterial genomes. Scientific Report, v. 13: 6238, p. 1 - 19, 2023. | en_US |
| ISSN | 2045-2322 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/58014 | |
| Language | eng | en_US |
| Publisher | Nature Portfolio | en_US |
| Rights | open access | |
| Subject in Portuguese | Relatório de surto de poly myx incar bap pneumoniae causando infecções intratáveis evidenciadas por testes de sinergia e genomas bacterianos | en_US |
| Title | Outbreak report of p oly myx incar bap ene m‑r esistant Klebsiella pneumoniae causing untreatable infections evidenced by synergy tests and bacterial genomes | en_US |
| Type | Article | |
| DOI | 10.1038/s41598-023-31901-4 | |
| Abstract | Polymyxin-carbapenem-resistant Klebsiella pneumoniae (PCR-Kp) with pan (PDR)- or extensively drugresistant
phenotypes has been increasingly described worldwide. Here, we report a PCR-Kp outbreak
causing untreatable infections descriptively correlated with bacterial genomes. Hospital-wide
surveillance of PCR-Kp was initiated in December-2014, after the first detection of a K. pneumoniae
phenotype initially classified as PDR, recovered from close spatiotemporal cases of a sentinel
hospital in Rio de Janeiro. Whole-genome sequencing of clinical PCR-Kp was performed to investigate
similarities and dissimilarities in phylogeny, resistance and virulence genes, plasmid structures and
genetic polymorphisms. A target phenotypic profile was detected in 10% (12/117) of the tested K.
pneumoniae complex bacteria recovered from patients (8.5%, 8/94) who had epidemiological links
and were involved in intractable infections and death, with combined therapeutic drugs failing to
meet synergy. Two resistant bacterial clades belong to the same transmission cluster (ST437) or might
have different sources (ST11). The severity of infection was likely related to patients’ comorbidities,
lack of antimicrobial therapy and predicted bacterial genes related to high resistance, survival, and
proliferation. This report contributes to the actual knowledge about the natural history of PCR-Kp
infection, while reporting from a time when there were no licensed drugs in the world to treat some of
these infections. More studies comparing clinical findings with bacterial genetic markers during clonal
spread are needed. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil / Ministério da Saúde. Hospital Federal Servidores do Estado. Rio de janeiro, RJ, Brasill / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro, Hospital Universitário Pedro Ernesto. Comitê de Controle da Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Ministério da Saúde. Hospital Federal Servidores do Estado. Rio de janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil / Departamento de Ciência da Saúde, Universidade Federal Rural do Semi-Árido (UFERSA). Mossoró, RN, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Anti‑Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Department of Medicine, Division of Infectious Diseases, School of Medicine, Wayne State University, Detroit, MI, USA. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Ministério da Saúde. Hospital Federal Servidores do Estado. Rio de janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | 4Anti‑Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Department of Medicine, Division of Infectious Diseases, School of Medicine, Wayne State University, Detroit, MI, USA. | en_US |
| Affilliation | Universidade do Estado do Rio de Janeiro. Departamento de Bioquímica, IBRAG. Rio de janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia Molecular Aplicada a Micobactérias. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Rio de Janeiro, RJ, Brasil. | en_US |
| Subject | Outbreak report of poly myx incar bap ene eneeumoniae | en_US |
| Subject | Causing untreatable infections | en_US |
| Subject | Evidenced by synergy tests and bacterial genomes | en_US |
| Subject | Outbreak report of poly myx incar bap ene Incar bap ene m‑r esistant Klebsiella pn | en_US |
