Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/221587
Title: Whole Genome Sequencing Analysis of Klebsiella pneumoniae Isolates from Health Care–Associated Bacteremia of Urinary Origin in Spain: Findings from the Multicenter ITUBRAS-2 Cohort Study
Author: Becerra Aparicio, Federico
Gómez Zorrilla, Silvia
Hernández García, Marta, 1986-
Xanthopoulou, Kyriaki
Gijón Cordero, Desirée
Siverio, Ana
Berbel, Dàmaris
Cercenado, Emilia
Rivera, Alba
Malet, Ana de
Xercavins, Mariona
Ruiz de Gopegui, Enrique
Canoura Fernández, Luís
Martínez Martínez, José Antonio
Seral, Cristina
Pozo, José Luis del
Cotarelo, Manuel
Ponz, Ricardo
Higgins, Paul G.
Duran Jordà, Xavier
Cantón, Rafael
Oliver, Antonio
Horcajada Gallego, Juan Pablo
Ruiz Garbajosa, Patricia
ITUBRAS-2 Group
Keywords: Klebsiella pneumoniae
Infeccions del tracte urinari
Resistència als medicaments
Klebsiella pneumoniae
Urinary tract infections
Drug resistance
Issue Date: 15-Mar-2025
Publisher: Oxford University Press (OUP)
Abstract: Background The objective of this study was to assess the microbiological and clinical features of Klebsiella pneumoniae health care-associated bacteremia of urinary origin (HCA-BUO) in Spain, with a focus on third-generation cephalosporin-(3GCR-Kp) and carbapenem-resistant K pneumoniae (CR-Kp) isolates.Methods A total of 96 (21.4%, 96/449) K pneumoniae blood isolates were prospectively collected from patients with HCA-BUO (n = 443) from 12 tertiary care hospitals in Spain (2017-2019). Antimicrobial susceptibility was determined (standard broth microdilution), and extended-spectrum beta-lactamase, AmpC, and carbapenemase production was screened. A subset of 55 K pneumoniae isolates was analyzed by whole genome sequencing (Illumina) to determine population structure, resistome, and virulome. Additionally, 13 of these isolates were subjected to long-read sequencing (Nanopore) for plasmid characterization. Patients' baseline and clinical characteristics were reviewed.Results 3GCR-Kp prevalence was 43.8% (42/96), mostly associated with extended-spectrum beta-lactamase production (34/96, 35.4%; mainly CTX-M-15, 32/34, 94.1%) and the dissemination of sequence type (ST)-307 (15/34, 44.1%) and other globally spread multidrug-resistant high-risk clones. CR-Kp prevalence was 9.4% (9/96); all isolates belonged to different STs and were mostly associated with carbapenemase production (6/9, 66.7%; mainly OXA-48-like, n = 3). Additionally, 3GCR-Kp and CR-Kp isolates showed higher content of other antibiotic resistance genes. Altogether, these episodes were associated with prior antibiotic use and receipt of inadequate empirical treatment.Conclusions There is a high prevalence of 3GCR and CR-Kp causing HCA-BUO in Spain, mainly driven by the dissemination of ST307/CTX-M-15 and other globally spread multidrug-resistant high-risk clones, challenging the selection of empirical and targeted treatments for these infections. There is a high prevalence of third-generation cephalosporin- and carbapenem-resistant Klebsiella pneumoniae causing health care-associated bacteremia of urinary origin in Spain. There is also a predominance of ST307/CTX-M-15 and other multidrug-resistant high-risk clones. Third-generation cephalosporin- and carbapenem-resistant K pneumoniae infections were associated with prior antibiotic use and inadequate empirical treatment.
Note: Reproducció del document publicat a: https://doi.org/10.1093/ofid/ofaf164
It is part of: Open Forum Infectious Diseases, 2025, vol. 12, num. 4
URI: https://hdl.handle.net/2445/221587
Related resource: https://doi.org/10.1093/ofid/ofaf164
ISSN: 2328-8957
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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