TY - JOUR
T1 - Genetic analysis of ESBL-producing Klebsiella pneumoniae isolated from UTI patients in Indonesia
AU - Yamasaki, Saya
AU - Shigemura, Katsumi
AU - Osawa, Kayo
AU - Kitagawa, Koichi
AU - Ishii, Aya
AU - Kuntaman, K.
AU - Shirakawa, Toshiro
AU - Miyara, Takayuki
AU - Fujisawa, Masato
N1 - Funding Information:
This study was supported by the Japan Initiative for Global Research Network on Infectious Diseases (J-GRID) from the Ministry of Education, Culture, Sport, Science and Technology in Japan (Grant No. 18fm0108004h0004), Japan Agency for Medical Research and Development (AMED) (Grant No. JP18fk0108019), JSPS KAKENHI in Japan (Grant Nos. 18K10045 and 19K09670), the Tahir Professorship from the University of Airlangga, Surabaya, Indonesia, The Institute of Tropical Disease, University of Airlangga, Surabaya, Indonesia, and the Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases. Collaborators: Ni Made Mertaniasih, Wahyu Setyarini, Dita Arizandy, Dadik Rahadjo. Saya Yamasaki received a special award conferred by the vitalizing committee of the west Japan branch of the Japanese Society of Chemotherapy in 2019.
Funding Information:
This study was supported by the Japan Initiative for Global Research Network on Infectious Diseases (J-GRID) from the Ministry of Education, Culture, Sport, Science and Technology in Japan (Grant No. 18fm0108004h0004 ), Japan Agency for Medical Research and Development (AMED) (Grant No. JP18fk0108019 ), JSPS KAKENHI in Japan (Grant Nos. 18K10045 and 19K09670) , the Tahir Professorship from the University of Airlangga, Surabaya, Indonesia, The Institute of Tropical Disease, University of Airlangga, Surabaya, Indonesia, and the Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases. Collaborators: Ni Made Mertaniasih, Wahyu Setyarini, Dita Arizandy, Dadik Rahadjo.
Publisher Copyright:
© 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
PY - 2021/1
Y1 - 2021/1
N2 - Introduction: Extended spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae is a serious concern for nosocomial infection and the emergence rate in Indonesia is higher than that in developed countries. The purpose of this study was to investigate the genetic characteristics of ESBL-producing K. pneumoniae isolated from UTI patients in Indonesia. Materials and methods: We collected K. pneumoniae resistant to ceftazidime or cefotaxime isolated from UTI patients in Dr. Soetomo's Academic Hospital in Surabaya, Indonesia in 2015. Ninety-four strains were identified as ESBL-producing bacteria by confirmation tests. The isolates were investigated by antimicrobial susceptibility testing with 20 drugs and ESBL gene detection, plasmid replicon typing and virulence genes as hypermucoviscous (HMV) strains were tested by the string test. Results: High rates of resistance to ciprofloxacin (86.2%), tetracycline (80.9%) and nalidixic acid (78.7%) were observed. CTX-M-15 was the most common ESBL gene (89.4%), 33 of which also carried SHV-type ESBL. IncF was the most prevalent plasmid replicon typing (47.6%). Sixteen (17.0%) strains were judged as HMV, all of which had rmpA and more than half of which had fimH, uge, and wab. IncL/M was the most common replicon plasmid in the HMV strains, and the difference in the positive rate was statistically significant (p = 0.0024). Conclusion: This study showed the high prevalence of multiple-drug resistant and predominately CTX-M-15-positive ESBL-producing K. pneumoniae in Indonesia. There was a correlation between IncL/M and the HMV phenotype in this study. As such hypervirulent strains continue to emerge, studying their dissemination with resistance determinants is an urgent priority.
AB - Introduction: Extended spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae is a serious concern for nosocomial infection and the emergence rate in Indonesia is higher than that in developed countries. The purpose of this study was to investigate the genetic characteristics of ESBL-producing K. pneumoniae isolated from UTI patients in Indonesia. Materials and methods: We collected K. pneumoniae resistant to ceftazidime or cefotaxime isolated from UTI patients in Dr. Soetomo's Academic Hospital in Surabaya, Indonesia in 2015. Ninety-four strains were identified as ESBL-producing bacteria by confirmation tests. The isolates were investigated by antimicrobial susceptibility testing with 20 drugs and ESBL gene detection, plasmid replicon typing and virulence genes as hypermucoviscous (HMV) strains were tested by the string test. Results: High rates of resistance to ciprofloxacin (86.2%), tetracycline (80.9%) and nalidixic acid (78.7%) were observed. CTX-M-15 was the most common ESBL gene (89.4%), 33 of which also carried SHV-type ESBL. IncF was the most prevalent plasmid replicon typing (47.6%). Sixteen (17.0%) strains were judged as HMV, all of which had rmpA and more than half of which had fimH, uge, and wab. IncL/M was the most common replicon plasmid in the HMV strains, and the difference in the positive rate was statistically significant (p = 0.0024). Conclusion: This study showed the high prevalence of multiple-drug resistant and predominately CTX-M-15-positive ESBL-producing K. pneumoniae in Indonesia. There was a correlation between IncL/M and the HMV phenotype in this study. As such hypervirulent strains continue to emerge, studying their dissemination with resistance determinants is an urgent priority.
KW - ESBL
KW - Hypermucoviscous
KW - Indonesia
KW - Klebsiella pneumoniae
UR - http://www.scopus.com/inward/record.url?scp=85090057650&partnerID=8YFLogxK
U2 - 10.1016/j.jiac.2020.08.007
DO - 10.1016/j.jiac.2020.08.007
M3 - Article
C2 - 32888833
AN - SCOPUS:85090057650
SN - 1341-321X
VL - 27
SP - 55
EP - 61
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
IS - 1
ER -
