Clinical and genomic analysis of hypermucoviscous Klebsiella pneumoniae isolates: Identification of new hypermucoviscosity associated genes

Meiling Jin; Meiling Jin; Tianye Jia; Xiong Liu; Xiong Liu; Meitao Yang; Meitao Yang; Na Zhang; Na Zhang; Jiali Chen; Jiali Chen; Xiaojing Yang; Xiaojing Yang; Shiyu Qin; Shiyu Qin; Fangni Liu; Fangni Liu; Yue Tang; Yong Wang; Jinpeng Guo; Yong Chen; Boan Li; Changjun Wang

doi:10.3389/fcimb.2022.1063406

Frontiers in Cellular and Infection Microbiology (Jan 2023)

Clinical and genomic analysis of hypermucoviscous Klebsiella pneumoniae isolates: Identification of new hypermucoviscosity associated genes

Meiling Jin,
Meiling Jin,
Tianye Jia,
Xiong Liu,
Xiong Liu,
Meitao Yang,
Meitao Yang,
Na Zhang,
Na Zhang,
Jiali Chen,
Jiali Chen,
Xiaojing Yang,
Xiaojing Yang,
Shiyu Qin,
Shiyu Qin,
Fangni Liu,
Fangni Liu,
Yue Tang,
Yong Wang,
Jinpeng Guo,
Yong Chen,
Boan Li,
Changjun Wang

Affiliations

Meiling Jin: School of Public Health, China Medical University, Shenyang, Liaoning, China
Meiling Jin: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Tianye Jia: The Clinical Laboratory, Fifth Medical Center of People's Liberation Army General Hospital, Beijing, China
Xiong Liu: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Xiong Liu: Department of Information, Chinese People’s Liberation Army Center for Disease Control and Prevention, Beijing, China
Meitao Yang: School of Public Health, China Medical University, Shenyang, Liaoning, China
Meitao Yang: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Na Zhang: School of Public Health, China Medical University, Shenyang, Liaoning, China
Na Zhang: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Jiali Chen: School of Public Health, China Medical University, Shenyang, Liaoning, China
Jiali Chen: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Xiaojing Yang: School of Public Health, China Medical University, Shenyang, Liaoning, China
Xiaojing Yang: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Shiyu Qin: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Shiyu Qin: College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
Fangni Liu: School of Public Health, China Medical University, Shenyang, Liaoning, China
Fangni Liu: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Yue Tang: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Yong Wang: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Jinpeng Guo: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Yong Chen: Department of Emergency Response, Chinese People's Liberation Army Center for Disease Control and Prevention, Beijing, China
Boan Li: The Clinical Laboratory, Fifth Medical Center of People's Liberation Army General Hospital, Beijing, China
Changjun Wang: Department of Health Service, Chinese People’s Liberation Army Center for Disease Control and Prevention, Beijing, China

DOI: https://doi.org/10.3389/fcimb.2022.1063406
Journal volume & issue: Vol. 12

Abstract

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IntroductionHypermucoviscous Klebsiella pneumoniae (HmKp) poses an emerging and highly pathogenic global health threat. This study aimed to investigate the clinical and genomic characteristics of HmKp isolates to better understand the virulence mechanisms of the hypermucoviscous (HMV) phenotype.MethodsFrom May 2018 to August 2021, 203 non-repeat K. pneumoniae isolates causing invasive infections were collected from a hospital in Beijing, China. Isolates were divided into HmKp (n=90, 44.3%) and non-HmKp (n=113, 55.7%) groups according to string test results.ResultsMultivariate regression showed that diabetes mellitus (odds ratio [OR]=2.20, 95% confidence interval (CI): 1.20-4.05, p=0.010) and liver abscess (OR=2.93, CI 95%:1.29-7.03, p=0.012) were associated with HmKp infections. K. pneumoniae was highly diverse, comprising 87 sequence types (STs) and 54 serotypes. Among HmKp isolates, ST23 was the most frequent ST (25/90, 27.8%), and the most prevalent serotypes were KL2 (31/90, 34.4%) and KL1 (27/90, 30.0%). Thirteen virulence genes were located on the capsular polysaccharide synthesis region of KL1 strains. HmKp isolates were sensitive to multiple antibiotics but carried more SHV-type extended spectrum β-lactamase (ESBL) resistance genes (p<0.05), suggesting that the emergence of ESBL-mediated multidrug resistance in HmKp should be monitored carefully during treatment. Phylogenetic analysis disclosed that HmKp isolates were highly diverse. Comparative genomic analysis confirmed that the HMV phenotype is a plasmid-encoded virulence factor. Seventeen HmKp genes were highly associated with HmKp, and included rmpAC, 7 iron-acquisition-related genes, and pagO, which may promote liver abscess formation.DiscussionThis investigation provides insight into the mechanisms producing the HMV phenotype.

Published in Frontiers in Cellular and Infection Microbiology

ISSN: 2235-2988 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Science: Microbiology
Website: http://www.frontiersin.org/Cellular-and-Infection-Microbiology

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