Antimicrobial resistance and AmpC production in ESBL-producing Klebsiella pneumoniae and Klebsiella quasipneumoniae: A retrospective study in Japanese clinical isolates

The study of Klebsiella quasipneumoniae, Klebsiella variicola, and AmpC production in extended-spectrum β-lactamase (ESBL)-producing Klebsiella in Japan is limited, and existing data are insufficient. This study aims to characterize Klebsiella species, determine AmpC production rates, and analyze an...

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Published in:PLOS ONE Vol. 19; no. 5; p. e0303353
Main Authors: Watanabe, Naoki, Watari, Tomohisa, Otsuka, Yoshihito, Ito, Masahiko, Yamagata, Kazufumi, Fujioka, Miyuki
Format: Journal Article
Language:English
Published: United States Public Library of Science (PLoS) 14.05.2024
Public Library of Science
Subjects:
AmpC gene
Anti-Bacterial Agents - pharmacology
Antibacterial agents
Antibiotics
Antimicrobial agents
Antimicrobial resistance
Bacterial pneumonia
Bacterial Proteins - genetics
Bacterial Proteins - metabolism
Beta lactamases
beta-Lactamases - genetics
beta-Lactamases - metabolism
Biology and Life Sciences
Cefoxitin
Ciprofloxacin
Clinical isolates
Drug resistance
Drug resistance in microorganisms
Drug Resistance, Bacterial - genetics
East Asian People
Ethylenediaminetetraacetic acid
Female
Genes
Genotype & phenotype
Genotypes
High resistance
Humans
Japan
Klebsiella
Klebsiella - drug effects
Klebsiella - enzymology
Klebsiella - genetics
Klebsiella - isolation & purification
Klebsiella Infections - drug therapy
Klebsiella Infections - epidemiology
Klebsiella Infections - microbiology
Klebsiella pneumoniae
Klebsiella pneumoniae - drug effects
Klebsiella pneumoniae - enzymology
Klebsiella pneumoniae - genetics
Klebsiella pneumoniae - isolation & purification
Klebsiella quasipneumoniae
Levofloxacin
Male
Medical laboratories
Medicine
Medicine and Health Sciences
Microbial Sensitivity Tests
Multiplexing
People and Places
Pneumonia
Q
Quality control
Quinolones
R
Research and Analysis Methods
Research Article
Retrospective Studies
Science
Statistical analysis
Sulfamethoxazole
Trimethoprim
β Lactamase
Japan
United States > US
ISSN:1932-6203, 1932-6203
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Summary:The study of Klebsiella quasipneumoniae, Klebsiella variicola, and AmpC production in extended-spectrum β-lactamase (ESBL)-producing Klebsiella in Japan is limited, and existing data are insufficient. This study aims to characterize Klebsiella species, determine AmpC production rates, and analyze antimicrobial resistance patterns in ESBL-producing Klebsiella isolates in Japan. A total of 139 clinical isolates of ESBL-producing Klebsiella were collected in Japan, along with their corresponding antimicrobial susceptibility profiles. The isolates were identified using a web-based tool. ESBL genes within the isolates were identified using multiplex PCR. Screening for AmpC-producing isolates was performed using cefoxitin disks, followed by multiplex PCR to detect the presence of AmpC genes. Antimicrobial resistance patterns were analyzed across the predominant ESBL genotypes. The web-based tool identified 135 isolates (97.1%) as Klebsiella pneumoniae and 4 (2.9%) as K. quasipneumoniae subsp. similipneumoniae, with no instances of K. variicola detected. Among K. pneumoniae, the CTX-M-1 group emerged as the predominant genotype (83/135, 61.5%), followed by K. quasipneumoniae subsp. similipneumoniae (3/4, 75.0%). The CTX-M-9 group was the second most prevalent genotype in K. pneumoniae (45/135, 33.3%). The high resistance rates were observed for quinolones (ranging from 46.7% to 63.0%) and trimethoprim/sulfamethoxazole (78.5%). The CTX-M-1 group exhibited higher resistance to ciprofloxacin (66/83, 79.5%) compared to the CTX-M-9 group (18/45, 40.0%), a trend also observed for levofloxacin and trimethoprim/sulfamethoxazole. Among the 16 isolates that tested positive during AmpC screening, only one K. pneumoniae isolates (0.7%) were confirmed to carry the AmpC gene. Klebsiella pneumoniae with the CTX-M-1 group is the most common ESBL-producing Klebsiella in Japan and showed a low proportion of AmpC production. These isolates are resistant to quinolones and trimethoprim/sulfamethoxazole, highlighting the challenge of managing this pathogen. The findings underscore the importance of broader research and continuous monitoring to address the resistance patterns of ESBL-producing Klebsiella.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0303353