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2021 Vol.51, Issue 3 Preview Page

Original Article

Molecular Characterization of Carbapenem-resistant, Colistin-resistant Klebsiella pneumoniae Isolates from a Tertiary Hospital in Jeonbuk, Korea
Tae Hee Lee12†
Minhyeon Cho1†
Jaehyeon Lee35
Joo-Hee Hwang45
Chang-Seop Lee45*
Kyung Min Chung125*
1Department of Microbiology and Immunology, Jeonbuk National University Medical School, Jeonju, Jeonbuk 54896, Republic of Korea
2Institute for Medical Science, Jeonbuk National University Medical School, Jeonju, Jeonbuk 54896, Republic of Korea
3Department of Laboratory Medicine, Jeonbuk National University Medical School, Jeonju, Jeonbuk 54896, Republic of Korea
4Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Jeonbuk 54896, Republic of Korea
5Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk 54907, Republic of Korea
*lcsmd@jbnu.ac.kr
*kmin@jbnu.ac.kr
† These authors contributed equally to this work.
September 2021. pp. 120-127
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Abstract

Klebsiella pneumoniae resistant to both carbapenem and colistin has become a major clinical challenge. Although such resistant isolates are rare, they have been sporadically reported from many areas of the world. To investigate the prevalence and resistant mechanisms to carbapenem-resistant, colistin-resistant K. pneumoniae among Korean patients, we selected these resistant K. pneumoniae from clinical isolates collected over a period of five years at a tertiary hospital in Jeonbuk, Korea. The minimum inhibitory concentration of a variety of antibiotics against the resistant isolates was determined by the macrodilution method or the E-test. PCR analysis was used to determine sequence types (STs) and identify the genes involved in resistance to carbapenem and colistin. In 338 K. pneumoniae clinical isolates, two exhibited both carbapenem and colistin resistance. The ST of these belonged to ST11 and ST258, the most prevalent STs with K. pneumoniae carbapenemases, but the isolates did not carry any prevalent carbapenem-hydrolyzing β-lactamase genes. The carbapenem resistance was mediated by loss of porins OmpK35 and/or OmpK36 associated with DHA-1 AmpC β-lactamase. The colistin resistance was caused by amino acid changes in PmrB, PmrC, PmrE, PmrK, and MgrB, including novel amino acid changes in PmrE and PmrK. We first reported novel carbapenem-resistant and colistin-resistant K. pneumoniae ST11 and ST258 with mutations within ompK35, ompK36, mgrB, and pmr genes in Korea. The results suggest that non- carbapenemase-producing carbapenem-resistant, colistin-resistant K. pneumoniae might be prevalent in Korea, and that better measures are necessary to control the spread of the resistant pathogen.

Keywords
K. pneumoniae
Carbapenem
Colistin
Porin
pmr genes
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Information
  • Publisher :The Korean Society for Microbiology
  • Publisher(Ko) :대한미생물학회
  • Journal Title :JOURNAL OF BACTERIOLOGY AND VIROLOGY
  • Volume : 51
  • No :3
  • Pages :120-127
  • Received Date :2021. 07. 29
  • Revised Date :2021. 08. 12
  • Accepted Date : 2021. 08. 14
  • DOI :https://doi.org/10.4167/jbv.2021.51.3.120
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