1887

Abstract

The three species , and are difficult to distinguish, owing to their similar biochemical properties, and are often confused in medical practice.

There is a scarcity of data comparing the clinical characteristics and antimicrobial susceptibility of , and . We believe that knowledge of the characteristics of each species will help in their better identification. Further, knowing the antimicrobial susceptibility of the species will help physicians in prescribing an effective treatment course for infections.

This study aimed to determine the clinical characteristics and antimicrobial resistance of , and isolated from human urine samples.

This study included 125 . strains isolated from human urine samples. Multiplex polymerase chain reaction was performed to identify , and . We retrospectively investigated the patient background, complications of bacteraemia, antimicrobial susceptibility and extended-spectrum β-lactamase (ESBL).

We identified 84 (67.2 %), 31 (24.8 %) and 10 strains (8 .0%) of , and , respectively. There was no difference in patient background and frequency of bacteraemia complications among these species. was significantly less susceptible than to ampicillin/sulbactam (=0.03) and piperacillin (<0.01). Furthermore, (79.8 %) was less susceptible to trimethoprim/sulfamethoxazole than (96.8 %) and (100 %). There were nine ESBL-producing strains (7.2 %), all of which were .

There was no difference in patient background and frequency of bacteraemia complications between , and isolated from urine. The three species showed a varying extent of antimicrobial susceptibility and ESBL production, and accurate identification is needed to understand the epidemiology of these species.

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2022-06-13
2022-06-25
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References

  1. Alves MS, Dias RC da S, de Castro ACD, Riley LW, Moreira BM. Identification of clinical isolates of indole-positive and indole-negative Klebsiella spp. J Clin Microbiol 2006; 44:3640–3646 [View Article] [PubMed]
    [Google Scholar]
  2. Garza-Ramos U, Silva-Sánchez J, Martínez-Romero E, Tinoco P, Pina-Gonzales M et al. Development of a multiplex-PCR probe system for the proper identification of Klebsiella variicola. BMC Microbiol 2015; 15:64 [View Article] [PubMed]
    [Google Scholar]
  3. Fonseca EL, Ramos N da V, Andrade BGN, Morais LLCS, Marin MFA et al. A one-step multiplex PCR to identify Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae in the clinical routine. Diagn Microbiol Infect Dis 2017; 87:315–317 [View Article] [PubMed]
    [Google Scholar]
  4. Rodrigues C, Passet V, Rakotondrasoa A, Brisse S. Identification of Klebsiella pneumoniae, Klebsiella quasipneumoniae, Klebsiella variicola and related phylogroups by MALDI-TOF mass spectrometry. Front Microbiol 2018; 9:3000 [View Article] [PubMed]
    [Google Scholar]
  5. Long SW, Linson SE, Ojeda Saavedra M, Cantu C, Davis JJ et al. Whole-genome sequencing of human clinical Klebsiella pneumoniae isolates reveals misidentification and misunderstandings of Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae. mSphere 2017; 2:e00290–00217 [View Article]
    [Google Scholar]
  6. Piepenbrock E, Higgins PG, Wille J, Xanthopoulou K, Zweigner J et al. Klebsiella variicola causing nosocomial transmission among neonates - an emerging pathogen?. J Med Microbiol 2020; 69:396–401 [View Article] [PubMed]
    [Google Scholar]
  7. Imai K, Ishibashi N, Kodana M, Tarumoto N, Sakai J et al. Clinical characteristics in blood stream infections caused by Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae: a comparative study, Japan, 2014-2017. BMC Infect Dis 2019; 19:946 [View Article] [PubMed]
    [Google Scholar]
  8. Gillies J, Inkster T. Klebsiella Pneumoniae Liver Abscesses and A Distinct Invasive Syndrome: Case Reports and Review of The Literature. JMM Case Rep 2015; 2: [View Article]
    [Google Scholar]
  9. Fang C-T, Chuang Y-P, Shun C-T, Chang S-C, Wang J-T. A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med 2004; 199:697–705 [View Article] [PubMed]
    [Google Scholar]
  10. Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing: CLSI document M100-S31 Wayne, PA: Clinical and Laboratory Standards Institute; 2021
    [Google Scholar]
  11. Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 2013; 48:452–458 [View Article] [PubMed]
    [Google Scholar]
  12. Potter RF, Lainhart W, Twentyman J, Wallace MA, Wang B et al. Population structure, antibiotic resistance, and uropathogenicity of Klebsiella variicola. mBio 2018; 9:e02481–02418 [View Article] [PubMed]
    [Google Scholar]
  13. Kim YJ, Kim SI, Kim YR, Wie SH, Lee HK et al. Virulence factors and clinical patterns of hypermucoviscous Klebsiella pneumoniae isolated from urine. Infect Dis (Lond) 2017; 49:178–184 [View Article] [PubMed]
    [Google Scholar]
  14. Patel R, Fang FC. Diagnostic stewardship: opportunity for a laboratory-infectious diseases partnership. Clin Infect Dis 2018; 67:799–801 [View Article] [PubMed]
    [Google Scholar]
  15. Haeggman S, Löfdahl S, Paauw A, Verhoef J, Brisse S. Diversity and evolution of the class A chromosomal beta-lactamase gene in Klebsiella pneumoniae. Antimicrob Agents Chemother 2004; 48:2400–2408 [View Article] [PubMed]
    [Google Scholar]
  16. Ohno Y, Nakamura A, Hashimoto E, Matsutani H, Abe N et al. Molecular epidemiology of carbapenemase-producing Enterobacteriaceae in a primary care hospital in Japan, 2010-2013. J Infect Chemother 2017; 23:224–229 [View Article] [PubMed]
    [Google Scholar]
  17. Nordmann P, Cuzon G, Naas T. The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis 2009; 9:228–236 [View Article] [PubMed]
    [Google Scholar]
  18. Pitout JDD, Nordmann P, Poirel L. Carbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance. Antimicrob Agents Chemother 2015; 59:5873–5884 [View Article] [PubMed]
    [Google Scholar]
  19. Harada S, Aoki K, Yamamoto S, Ishii Y, Sekiya N et al. Clinical and molecular characteristics of Klebsiella pneumoniae isolates causing bloodstream infections in japan: occurrence of hypervirulent infections in health care. J Clin Microbiol 2019; 57:e01206-19 [View Article] [PubMed]
    [Google Scholar]
  20. The Japanese Ministry of Health and Welfare Japan Nosocomial Infections Surveillance (JANIS): Annual Open Report 2020. Tokyo: The Japanese Ministry of Health and Welfare; 2021 https://janis.mhlw.go.jp/english/report/index.html accessed 21 January 2022
  21. Robin F, Beyrouthy R, Bonacorsi S, Aissa N, Bret L et al. Inventory of extended-spectrum-β-lactamase-producing Enterobacteriaceae in France as assessed by a multicenter study. Antimicrob Agents Chemother 2017; 61:e01911–01916 [View Article] [PubMed]
    [Google Scholar]
  22. Ríos E, López MC, Rodríguez-Avial I, Culebras E, Picazo JJ. Detection of Escherichia coli ST131 clonal complex (ST705) and Klebsiella pneumoniae ST15 among faecal carriage of extended-spectrum β-lactamase- and carbapenemase-producing Enterobacteriaceae. J Med Microbiol 2017; 66:169–174 [View Article] [PubMed]
    [Google Scholar]
  23. Lee MY, Ko KS, Kang C-I, Chung DR, Peck KR et al. High prevalence of CTX-M-15-producing Klebsiella pneumoniae isolates in Asian countries: diverse clones and clonal dissemination. Int J Antimicrob Agents 2011; 38:160–163 [View Article] [PubMed]
    [Google Scholar]
  24. Dziri R, Klibi N, Alonso CA, Said LB, Bellaaj R et al. Characterization of extended-spectrum β-lactamase (ESBL)-producing Klebsiella, Enterobacter, and Citrobacter obtained in environmental samples of a Tunisian hospital. Diagn Microbiol Infect Dis 2016; 86:190–193 [View Article] [PubMed]
    [Google Scholar]
  25. Kakuta N, Nakano R, Nakano A, Suzuki Y, Masui T et al. Molecular characteristics of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in Japan: Predominance of CTX-M-15 and emergence of hypervirulent clones. Int J Infect Dis 2020; 98:281–286 [View Article] [PubMed]
    [Google Scholar]
  26. Eibach D, Belmar Campos C, Krumkamp R, Al-Emran HM, Dekker D et al. Extended spectrum beta-lactamase producing Enterobacteriaceae causing bloodstream infections in rural Ghana, 2007-2012. Int J Med Microbiol 2016; 306:249–254 [View Article] [PubMed]
    [Google Scholar]
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