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, Margaret M. C. Lam2
, Ryan R. Wick2,3
, Kelly L. Wyres2
, Michael Bachman4
, Stephen Baker5
, Katherine Barry6, Sylvain Brisse7
, Susana Campino1
, Alexandra Chiaverini8
, Daniela Maria Cirillo9
, Taane Clark1
, Jukka Corander10
, Marta Corbella11
, Alessandra Cornacchia8
, Aline Cuénod12
, Nicola D'Alterio8, Federico Di Marco9
, Pilar Donado-Godoy13
, Adrian Egli12
, Refath Farzana14
, Edward J. Feil15
, Aasmund Fostervold16
, Claire L. Gorrie3
, Brekhna Hassan17
, Marit Andrea Klokkhammer Hetland16
, Le Nguyen Minh Hoa18, Le Thi Hoi19, Benjamin Howden3
, Odion O. Ikhimiukor20
, Adam W. J. Jenney3
, Håkon Kaspersen21
, Fahad Khokhar5, Thongpan Leangapichart21
, Małgorzata Ligowska-Marzęta22, Iren Høyland Löhr16
, Scott W. Long23
, Amy J. Mathers6
, Andrew G. McArthur24
, Geetha Nagaraj25
, Anderson O. Oaikhena20
, Iruka N. Okeke20
, João Perdigão26
, Hardik Parikh6
, My H. Pham27, Francesco Pomilio8
, Niclas Raffelsberger28
, Andriniaina Rakotondrasoa29
, K. L. Ravi Kumar25, Leah W. Roberts30
, Carla Rodrigues7
, Ørjan Samuelsen31,32
, Kirsty Sands14
, Davide Sassera11,33
, Helena Seth-Smith12
, Varun Shamanna25
, Norelle L. Sherry3
, Sonia Sia34, Anton Spadar1
, Nicole Stoesser35
, Marianne Sunde21
, Arnfinn Sundsfjord31,36
, Pham Ngoc Thach18, Nicholas R. Thomson27
, Harry A. Thorpe10
, M. Estée Torok5
, Van Dinh Trang18, Nguyen Vu Trung19, Jay Vornhagen37
, Timothy Walsh14
, Ben Warne5
, Hayley Wilson38, Gerard D. Wright24
, Kathryn E. Holt1,2
and KlebNET-GSP AMR Genotype-Phenotype Group
Interpreting the phenotypes of bla SHV alleles in Klebsiella pneumoniae genomes is complex. Whilst all strains are expected to carry a chromosomal copy conferring resistance to ampicillin, they may also carry mutations in chromosomal bla SHV alleles or additional plasmid-borne bla SHV alleles that have extended-spectrum β-lactamase (ESBL) activity and/or β-lactamase inhibitor (BLI) resistance activity. In addition, the role of individual mutations/a changes is not completely documented or understood. This has led to confusion in the literature and in antimicrobial resistance (AMR) gene databases [e.g. the National Center for Biotechnology Information (NCBI) Reference Gene Catalog and the β-lactamase database (BLDB)] over the specific functionality of individual sulfhydryl variable (SHV) protein variants. Therefore, the identification of ESBL-producing strains from K. pneumoniae genome data is complicated. Here, we reviewed the experimental evidence for the expansion of SHV enzyme function associated with specific aa substitutions. We then systematically assigned SHV alleles to functional classes (WT, ESBL and BLI resistant) based on the presence of these mutations. This resulted in the re-classification of 37 SHV alleles compared with the current assignments in the NCBI’s Reference Gene Catalog and/or BLDB (21 to WT, 12 to ESBL and 4 to BLI resistant). Phylogenetic and comparative genomic analyses support that (i) SHV-1 (encoded by bla SHV-1) is the ancestral chromosomal variant, (ii) ESBL- and BLI-resistant variants have evolved multiple times through parallel substitution mutations, (iii) ESBL variants are mostly mobilized to plasmids and (iv) BLI-resistant variants mostly result from mutations in chromosomal bla SHV. We used matched genome–phenotype data from the KlebNET-GSP AMR Genotype-Phenotype Group to identify 3999 K. pneumoniae isolates carrying one or more bla SHV alleles but no other acquired β-lactamases to assess genotype–phenotype relationships for bla SHV. This collection includes human, animal and environmental isolates collected between 2001 and 2021 from 24 countries. Our analysis supports that mutations at Ambler sites 238 and 179 confer ESBL activity, whilst most omega-loop substitutions do not. Our data also provide support for the WT assignment of 67 protein variants, including 8 that were noted in public databases as ESBL. These eight variants were reclassified as WT because they lack ESBL-associated mutations, and our phenotype data support susceptibility to third-generation cephalosporins (SHV-27, SHV-38, SHV-40, SHV-41, SHV-42, SHV-65, SHV-164 and SHV-187). The approach and results outlined here have been implemented in Kleborate v2.4.1 (a software tool for genotyping K. pneumoniae), whereby known and novel bla SHV alleles are classified based on causative mutations. Kleborate v2.4.1 was updated to include ten novel protein variants from the KlebNET-GSP dataset and all alleles in public databases as of November 2023. This study demonstrates the power of sharing AMR phenotypes alongside genome data to improve the understanding of resistance mechanisms.
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