Klebsiella pneumonia in Sudan: Multidrug Resistance, Polyclonal Dissemination, and Virulence.
Einas A OsmanMaho YokoyamaHisham N AltaybDaire CantillonJulia WilleHarald SeifertPaul G HigginsLeena Al-HassanPublished in: Antibiotics (Basel, Switzerland) (2023)
The emergence and global expansion of hyper-virulent and multidrug resistant (MDR) Klebsiella pneumoniae is an increasing healthcare threat worldwide. The epidemiology of MDR K. pneumoniae is under-characterized in many parts of the world, particularly Africa. In this study, K. pneumoniae isolates from hospitals in Khartoum, Sudan, have been whole-genome sequenced to investigate their molecular epidemiology, virulence, and resistome profiles. Eighty-six K. pneumoniae were recovered from patients in five hospitals in Khartoum between 2016 and 2020. Antimicrobial susceptibility was performed by disk-diffusion and broth microdilution. All isolates underwent whole genome sequencing using Illumina MiSeq; cgMLST was determined using Ridom SeqSphere+, and 7-loci MLST virulence genes and resistomes were identified. MDR was observed at 80%, with 35 isolates (41%) confirmed carbapenem-resistant. Thirty-seven sequence types were identified, and 14 transmission clusters (TC). Five of these TCs involved more than one hospital. Ybt9 was the most common virulence gene detected, in addition to some isolates harbouring iuc and rmp1 . There is a diverse population of K. pneumoniae in Khartoum hospitals, harbouring multiple resistance genes, including genes coding for ESBLs, carbapenemases, and aminoglycoside-modifying enzymes, across multiple ST's. The majority of isolates were singletons and transmissions were rare.
Keyphrases
- multidrug resistant
- klebsiella pneumoniae
- escherichia coli
- healthcare
- pseudomonas aeruginosa
- genome wide
- acinetobacter baumannii
- drug resistant
- staphylococcus aureus
- antimicrobial resistance
- biofilm formation
- gram negative
- genome wide identification
- genetic diversity
- end stage renal disease
- bioinformatics analysis
- respiratory tract
- ejection fraction
- dna methylation
- genome wide analysis
- newly diagnosed
- chronic kidney disease
- cystic fibrosis
- peritoneal dialysis
- transcription factor
- genome wide association study
- adverse drug
- patient reported outcomes
- emergency department
- gene expression
- social media
- intensive care unit
- health information
- respiratory failure
- genome wide association