Emergence of Carbapenemase-Producing Hypervirulent Klebsiella pneumoniae in Switzerland

Antimicrob Agents Chemother. 2023 Mar 16;67(3):e0142422. doi: 10.1128/aac.01424-22. Epub 2023 Feb 28.

Abstract

Increasing occurrence of multidrug-resistant (MDR) and hypervirulent (hv) Klebsiella pneumoniae (MDR-hvKp) convergent clones is being observed. Those strains have the potential of causing difficult-to-treat infections in healthy adults with an increased capacity for mortality. It is therefore crucial to track their dissemination to prevent their further spread. The aim of our study was to investigate the occurrence of carbapenemase-producing hvKp isolates in Switzerland and to determine their genetic profile. A total of 279 MDR carbapenemase-producing K. pneumoniae from patients hospitalized all over Switzerland was investigated, and a rate of 9.0% K. pneumoniae presenting a virulence genotype was identified. Those isolates produced either KPC, NDM, or OXA-48 and had been either recovered from rectal swabs, urine, and blood. A series of previously reported K. pneumoniae clones such as ST23-K1, ST395-K2, and ST147-K20 or ST147-K64 were identified. All the isolates defined as MDR-hvKp (4.7%) possessed the aerobactin and the yersiniabactin clusters. The ST23-K1s were the only isolates presenting the colibactin cluster and achieved higher virulence scores. This study highlights the occurrence and circulation of worrisome MDR-hvKp and MDR nonhypervirulent K. pneumoniae (MDR-nhv-Kp) isolates in Switzerland. Our findings raise an alert regarding the need for active surveillance networks to track and monitor the spread of such successful hybrid clones representing a public health threat worldwide.

Keywords: Klebsiella pneumoniae; carbapenemase; convergent clones; hypervirulence; multidrug resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / genetics
  • Humans
  • Klebsiella Infections* / drug therapy
  • Klebsiella Infections* / epidemiology
  • Klebsiella pneumoniae*
  • Switzerland / epidemiology
  • beta-Lactamases / genetics

Substances

  • carbapenemase
  • Bacterial Proteins
  • beta-Lactamases
  • Anti-Bacterial Agents