AUTHOR=Zhu Chendi , Liyanapathirana Veranja , Li Carmen , Pinto Vasanthi , Hui Mamie , Lo Norman , Wong Kam T. , Dissanayake Nilanthi , Ip Margaret 

TITLE=Characterizing Mobilized Virulence Factors and Multidrug Resistance Genes in Carbapenemase-Producing Klebsiella pneumoniae in a Sri Lankan Hospital

JOURNAL=Frontiers in Microbiology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.02044

DOI=10.3389/fmicb.2018.02044

ISSN=1664-302X

ABSTRACT=<p>Limited data is available on the epidemiology and characteristics of carbapenem-resistant <italic>Enterobacteriaceae</italic> (CRE) and their associated plasmids or virulence determinants from Sri Lanka. Through whole genome sequencing of CREs from the intensive care units of a Sri Lankan teaching hospital, we identified a carbapenemase gene, <italic>bla</italic><sub>OXA–181</sub> in 10 carbapenemase-producing <italic>Klebsiella pneumoniae</italic> isolates (two strains of ST437 and eight strains of ST147) from 379 respiratory specimens. <italic>bla</italic><sub>OXA–181</sub> was carried in three variants of ColE-type plasmids. <italic>K. pneumoniae</italic> strains with <italic>ompK36</italic> variants showed high minimum inhibitory concentrations to carbapenem. Furthermore, genes encoding for extended spectrum β-lactamases (ESBL), plasmid-mediated quinolone resistance (PMQR) determinants (<italic>qnr</italic>, <italic>aac(6′)-Ib-cr</italic>, and <italic>oqxAB</italic>) were present in all 10 strains. Amino acid substitution in chromosomal quinolone resistance-determining regions (QRDRs) <italic>gyrA</italic> (Ser83Ile) and <italic>parC</italic> (Ser80Ile) were also observed. All strains had yersiniabactin genes on mobile element ICE<italic>kp</italic>. Strict infection control practices and judicious use of antibiotics are warranted to prevent further spread of multidrug-resistant <italic>K. pneumoniae</italic>.</p>