Increased Serum Resistance in Klebsiella Pneumoniae Strains Producing Extended-spectrum Beta-lactamases

Overview

Journal Antimicrob Agents Chemother

Publisher American Society for Microbiology

Specialty Pharmacology

Date 2004 Aug 26

PMID 15328114

Citations 32

Authors

H Sahly

H Aucken

V J Benedi

C Forestier

V Fussing

D S Hansen

I Ofek

R Podschun

D Sirot

J M Tomas

D Sandvang

U Ullmann

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to determine whether there is an association between serum resistance, O serotypes, and the production of extended-spectrum beta-lactamases (ESBLs) in Klebsiella pneumoniae. Ninety ESBL-producing and 178 non-ESBL-producing K. pneumoniae isolates gathered in five European countries were O serotyped and tested for sensitivity to the serum's bactericidal effect. The frequency of serum-resistant isolates was higher among ESBL-producing strains (30%; 27/90 isolates) than among non-ESBL-producing strains (17.9%; 32/178 isolates) (P = 0.037; odds ratio [OR] = 1.96; 95% confidence interval [95% CI] = 1.08 to 3.53). Although O1 was the most common O serotype in both Klebsiella groups, its frequency among ESBL-producing strains was significantly higher (59%; 53/90 isolates) than among non-ESBL producers (36%; 64/178 isolates) (P = 0.0006; OR = 2.5; 95% CI = 1.52 to 4.29). Furthermore, the prevalence of the O1 serotype was higher among serum-resistant strains of both ESBL-producing (74%; 20/27isolates) and non-ESBL producers (75%; 24/32 isolates) than among serum-sensitive ESBL producers (52.4%; 33/63 isolates) and non-ESBL producers (27.4%; 40/146 isolates). Serum resistance among ESBL-producing strains (36%; 17/47 isolates) versus non-ESBL-producing strains (16%; 27/166 isolates) was also significantly higher after the exclusion of clonal strains (P = 0.0056; OR = 2.9; 95% CI = 1.41 to 6.01). Sixteen ESBL types were detected, among which the frequency of serum resistance was significantly lower among the SHV-producing strains (9/48 isolates) than among the TEM producers (16/35 isolates) (P = 0.016; OR = 3.65; CI = 1.3 to 9.7). Curing ESBL-coding plasmids did not influence the serum resistance of the bacteria; all six plasmid-cured derivatives maintained serum resistance. The present findings suggest that ESBL-producing strains have a greater pathogenic potential than non-ESBL-producing strains, but the linkage between O serotypes, serum resistance, and ESBL production remains unclear at this stage.

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References

Porat R, Johns M, McCabe W . Selective pressures and lipopolysaccharide subunits as determinants of resistance of clinical isolates of gram-negative bacilli to human serum. Infect Immun. 1987; 55(2):320-8. PMC: 260329. DOI: 10.1128/iai.55.2.320-328.1987. View

TOIVANEN P, Hansen D, Mestre F, Lehtonen L, Vaahtovuo J, Vehma M . Somatic serogroups, capsular types, and species of fecal Klebsiella in patients with ankylosing spondylitis. J Clin Microbiol. 1999; 37(9):2808-12. PMC: 85385. DOI: 10.1128/JCM.37.9.2808-2812.1999. View

Jarlier V, Nicolas M, Fournier G, Philippon A . Extended broad-spectrum beta-lactamases conferring transferable resistance to newer beta-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility patterns. Rev Infect Dis. 1988; 10(4):867-78. DOI: 10.1093/clinids/10.4.867. View

Darfeuille-Michaud A, Jallat C, Aubel D, Sirot D, Rich C, Sirot J . R-plasmid-encoded adhesive factor in Klebsiella pneumoniae strains responsible for human nosocomial infections. Infect Immun. 1992; 60(1):44-55. PMC: 257501. DOI: 10.1128/iai.60.1.44-55.1992. View

Merino S, Camprubi S, Alberti S, Benedi V, Tomas J . Mechanisms of Klebsiella pneumoniae resistance to complement-mediated killing. Infect Immun. 1992; 60(6):2529-35. PMC: 257192. DOI: 10.1128/iai.60.6.2529-2535.1992. View

Alberti S, Marques G, Camprubi S, Merino S, Tomas J, Vivanco F . C1q binding and activation of the complement classical pathway by Klebsiella pneumoniae outer membrane proteins. Infect Immun. 1993; 61(3):852-60. PMC: 302811. DOI: 10.1128/iai.61.3.852-860.1993. View

Podschun R, Sievers D, Fischer A, Ullmann U . Serotypes, hemagglutinins, siderophore synthesis, and serum resistance of Klebsiella isolates causing human urinary tract infections. J Infect Dis. 1993; 168(6):1415-21. DOI: 10.1093/infdis/168.6.1415. View

Kelly R, Severn W, Richards J, Perry M, Maclean L, Tomas J . Structural variation in the O-specific polysaccharides of Klebsiella pneumoniae serotype O1 and O8 lipopolysaccharide: evidence for clonal diversity in rfb genes. Mol Microbiol. 1993; 10(3):615-25. DOI: 10.1111/j.1365-2958.1993.tb00933.x. View

Di Martino P, Livrelli V, Sirot D, Joly B, Darfeuille-Michaud A . A new fimbrial antigen harbored by CAZ-5/SHV-4-producing Klebsiella pneumoniae strains involved in nosocomial infections. Infect Immun. 1996; 64(6):2266-73. PMC: 174065. DOI: 10.1128/iai.64.6.2266-2273.1996. View

10.

Jacoby G . Antimicrobial-resistant pathogens in the 1990s. Annu Rev Med. 1996; 47:169-79. DOI: 10.1146/annurev.med.47.1.169. View

11.

Livrelli V, De Champs C, Di Martino P, Darfeuille-Michaud A, Forestier C, Joly B . Adhesive properties and antibiotic resistance of Klebsiella, Enterobacter, and Serratia clinical isolates involved in nosocomial infections. J Clin Microbiol. 1996; 34(8):1963-9. PMC: 229163. DOI: 10.1128/jcm.34.8.1963-1969.1996. View

12.

Livermore D, Yuan M . Antibiotic resistance and production of extended-spectrum beta-lactamases amongst Klebsiella spp. from intensive care units in Europe. J Antimicrob Chemother. 1996; 38(3):409-24. DOI: 10.1093/jac/38.3.409. View

13.

Alberti S, Alvarez D, Merino S, Casado M, Vivanco F, Tomas J . Analysis of complement C3 deposition and degradation on Klebsiella pneumoniae. Infect Immun. 1996; 64(11):4726-32. PMC: 174438. DOI: 10.1128/iai.64.11.4726-4732.1996. View

14.

Sandvang D . Novel streptomycin and spectinomycin resistance gene as a gene cassette within a class 1 integron isolated from Escherichia coli. Antimicrob Agents Chemother. 1999; 43(12):3036-8. PMC: 89612. DOI: 10.1128/AAC.43.12.3036. View

15.

Winokur P, Canton R, Casellas J, Legakis N . Variations in the prevalence of strains expressing an extended-spectrum beta-lactamase phenotype and characterization of isolates from Europe, the Americas, and the Western Pacific region. Clin Infect Dis. 2001; 32 Suppl 2:S94-103. DOI: 10.1086/320182. View

16.

Coque T, Oliver A, Baquero F, Canton R . Genes encoding TEM-4, SHV-2, and CTX-M-10 extended-spectrum beta-lactamases are carried by multiple Klebsiella pneumoniae clones in a single hospital (Madrid, 1989 to 2000). Antimicrob Agents Chemother. 2002; 46(2):500-10. PMC: 127031. DOI: 10.1128/AAC.46.2.500-510.2002. View

17.

Hansen D, Skov R, Benedi J, Sperling V, Kolmos H . Klebsiella typing: pulsed-field gel electrophoresis (PFGE) in comparison with O:K-serotyping. Clin Microbiol Infect. 2002; 8(7):397-404. DOI: 10.1046/j.1469-0691.2002.00411.x. View

18.

De Melo M, Figueiredo A, Ferreira-Carvalho B . Antimicrobial susceptibility patterns and genomic diversity in strains of Streptococcus pyogenes isolated in 1978-1997 in different Brazilian cities. J Med Microbiol. 2003; 52(Pt 3):251-258. DOI: 10.1099/jmm.0.04938-0. View

19.

Simberkoff M, Ricupero I, Rahal Jr J . Host resistance to Serratia marcescens infection: serum bactericidal activity and phagocytosis by normal blood leukocytes. J Lab Clin Med. 1976; 87(2):206-17. View

20.

Schoolnik G, Buchanan T, Holmes K . Gonococci causing disseminated gonococcal infection are resistant to the bactericidal action of normal human sera. J Clin Invest. 1976; 58(5):1163-73. PMC: 333284. DOI: 10.1172/JCI108569. View