(2018) Outbreak of hypervirulent Klebsiella pneumoniae harboring blaVIM-2 among mechanically ventilated drug poisoning patients with high mortality outcome in Iran. Journal of global antimicrobial resistance. ISSN 2213-7173 (Electronic) 2213-7165 (Linking)
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Abstract
OBJECTIVES: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are associated with increased rate of treatment failure and death. Several studies have reported isolates with combined hypervirulent and antibiotics resistance phenotype. METHODS: Herein, we studied molecular characteristics of hypervirulent K. pneumoniae isolated from mechanically ventilated patients admitted to toxicological ICU. String test, antibiotic susceptibility, virulence factors and plasmid replicon typing were carried out. Finally, clonal relatedness of isolates were analyzed by PFGE and MLST. RESULTS: In this study, hypervirulent K. pneumoniae (hvKP) accounted for 9.4 (5/53) of K. pneumoniae isolated from ventilator-associated pneumonia (VAP) among patients admitted to ICU with acute drug poisoning. The mortality rate were 7.54 (4/53) among KP infected patients. All fatal KP were hvKP isolates and resistant to imipenem and harbored aacA7, blaVIM-2 and dhfrI cassettes arrangement in class 1 integron. Isolates were shown Pasteur's MLST ST23 and exhibited similar PFGE patterns. Plasmid analysis revealed class 1 integron harbored blaVIM-2 located on approximately 45 Kb plasmid with IncN incompatibility group. DISCUSSION: In the present study, we described emergence of VIM-2-producing hypervirulent K. pneumoniae serotype K1/ST23 in outbreak with high mortality in the hospital's toxicological ICU. It seems that we must alert and prepare our surveillance system for appearance, expansion and clinical importance of new clones of K. pneumoniae associated with highly antimicrobial resistance and robust virulence capabilities.
Item Type: | Article |
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Keywords: | Hypervirulent Klebsiella pneumoniae Ventilated associated pneumoniae bla(VIM-2) |
Journal or Publication Title: | Journal of global antimicrobial resistance |
Journal Index: | ISI, Pubmed, Scopus |
Identification Number: | 10.1016/j.jgar.2018.06.020 |
ISSN: | 2213-7173 (Electronic) 2213-7165 (Linking) |
Depositing User: | دکتر محبوبه عبداللهی |
URI: | http://eprints.thums.ac.ir/id/eprint/636 |
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