The effect of carbapenem resistance in Klebsiellae on infection outcomes in animals and birds

It is often said that the emergence of antimicrobial drug resistance(AMR)in pathogens is the major cause of mortality.In the present study,clinical microbiology data on infections caused by Klebsiella pneumoniae strains and their antimicrobial drug resistance specifically to carbapenems retrieved from Clinical Epidemiology database of the Institute were analysed to determine the impact of carbapenem resistance in Klebsiellae isolated from the clinical samples of veterinary cases and outcome of the infection because in a few recent reports it is claimed that the presence of carbapenem-resistant Klebsiellae is associated with higher mortality in humans due to Klebsiella infections.The retrospective analysis of Klebsiella infections in animals and birds revealed that 21.8%of K.pneumoniae causing pneumonic or septicemic infections were carbapenem-resistant but the carbapenem resistance was not associated with increased numbers of deaths or recovery.It may be probably due to the fact that carbapenem drugs were not used for the treatment of infected animals and carbapenem resistance may not be associated with the lethality potential of Klebsiellae.

Klebsiella pneumoniae infections after liver transplantation:Drug resistance and distribution of pathogens,risk factors,and influence on outcomes

BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneumoniae infections(KPIs)in the bloodstream are common in LT recipients.We hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT recipients.AIM To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with outcomes.METHODS This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January 2023.We investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression analysis.RESULTS KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 d.Of 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin.Female sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for KPI.CRKP infections,but not KPIs,were risk factors for 6-month all-cause mortality post-LT.CONCLUSION KPIs occur frequently and rapidly after LT.Risk factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter duration.CRKP infections,and not KPIs,affect mortality.

Identification of Mulberry Bacterial Blight Caused by Klebsiella oxytoca in Bazhong,Sichuan,China

To provide a scientific basis for controlling mulberry bacterial blight in Bazhong,Sichuan,China(BSC),this study aimed to isolate and purify pathogenic bacteria from diseased branches of mulberry trees in the region and to clarify their taxonomic status using morphological observation,physiological and biochemical detection,molecular-level identification,and the construction of a phylogenetic tree.A total of 218 bacterial strains were isolated from samples of diseased mulberry branches.Of these,7 strains were identified as pathogenic bacteria based on pathogenicity tests conducted in accordance with Koch’s postulates.Preliminary findings from the analysis of the 16S rRNA sequence indicated that the 7 pathogenic bacteria are members of Klebsiella spp.Morphological observation revealed that the pathogenic bacteria were oval-shaped and had capsules but no spores.They could secrete pectinase,cellulase,and protease and were able to utilize D-glucose,D-mannose,D-maltose,and D-Cellobiose.The 7 strains of pathogenic bacteria exhibited the highest homology with Klebsiella oxytoca.This study identifies Klebsiella oxytoca as the causative agent of mulberry bacterial blight in BSC,laying the foundation for the prevention and control of this pathogen and further investigation into its pathogenic mechanism.

Prevalence and Antibiotic Resistance of Urinary Tract Pathogens, with Molecular Identification of Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter spp., Using Multiplex Real-Time PCR

Urinary tract infections (UTIs) caused by uropathogens are a significant public health problem, and their treatment primarily relies on antibiotic therapy. However, the increasing global development of antibiotic resistance necessitates updating diagnostic techniques to ensure higher sensitivity and specificity, especially with advancements in science and medicine. This study aimed to evaluate the prevalence of UTIs and antibiotic resistance profiles through urine culture, as well as to identify Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter spp. in urine samples using a molecular approach with multiplex real-time PCR. From May 3 to July 25, 2023, at the Pietro Annigoni Biomolecular Research Center (CERBA) and Saint Camille Hospital of Ouagadougou (HOSCO), 209 urine samples collected from patients with suspected UTIs were analyzed using both urine culture and multiplex real-time PCR. Among the 209 patients, 52.15% were male and 47.85% female, with an average age of 46.87 ± 21.33 years. Urine cultures revealed an overall UTI prevalence of 23.44%, with a prevalence of 8.13% in men versus 15.31% in women (P = 0.023). The bacterial prevalence rates were as follows: Escherichia coli (12.92%), Klebsiella spp. (7.18%), Enterobacter cloacae (1.44%), Staphylococcus aureus (0.96%), and other bacteria. Klebsiella spp. demonstrated 100% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, while Escherichia coli showed 96.2% and 65.4% resistance to Amoxicillin and Amoxicillin/Clavulanic Acid, respectively. PCR analysis of the target bacteria revealed mono-infection prevalence rates of Klebsiella pneumoniae (10.39%), Klebsiella oxytoca (7.79%), and Acinetobacter spp. (7.79%), along with a co-infection prevalence rate of Klebsiella pneumoniae/Acinetobacter spp. (1.30%). This study demonstrated that PCR, with its high sensitivity and specificity, could effectively distinguish Klebsiella pneumoniae from Klebsiella oxytoca and detect Acinetobacter spp. in less than 24 hours—something urine culture alone could not achieve. The relative ease of automating urine PCR testing, combined with its diagnostic accuracy and rapid turnaround time, makes it a valuable addition to modern medical practice for the laboratory diagnosis of UTIs.

Klebsiella oxytoca EN-B2高效转化羟胺和亚硝态氮的影响因素研究

羟胺和亚硝态氮对动植物具有毒害作用,并通过污染环境进一步危害人类健康。本研究以实验室前期分离获得的一株高效转化羟胺和亚硝态氮的克雷伯氏菌(Klebsiella oxytoca)为研究对象,探究不同环境因素对该菌株同时去除羟胺和亚硝态氮的影响。结果表明,在碳源为丁二酸钠,接菌量0.4×10^(8) CFU、碳氮比(C/N)15、温度25℃、转速150 r/min和初始pH值8.0条件下,菌株EN-B2对羟胺、亚硝态氮、总氮的去除效率最高,去除率分别达到了99.42%、100.00%和87.76%。此外,本研究通过向亚硝态氮体系中添加不同浓度的羟胺,进一步探讨了羟胺对菌株EN-B2反硝化过程的影响。结果表明,当体系中羟胺浓度超过3 mg/L后,随着羟胺浓度的进一步增加,该菌株在相同时间下亚硝态氮去除速率降低。本研究有助于理解Klebsiella oxytoca EN-B2在羟胺和亚硝态氮混合体系中的除氮特性,为氮污染废水的处理工艺提供重要参考。

Klebsiella as an α-tocopherol source facilitating Lactobacillus plantarum fermentation in rice straw silage

Silage serves as the indispensable diet of ruminants,the increasing mechanism of α-tocopherol during silage making is unclear.Rice straw lacks chlorophyll after harvesting the grain,this can eliminate the impact of tocopherols formed by the breakdown of chlorophyll.Here,we explored the α-tocopherol source,its influencing factor,and its relationship with dominant lactic acid bacteria in rice straw silage treated without or with different additives(sodium benzoate,Lactobacillus plantarum,cell wall degrading enzymes,the combination of L.plantarum and cell wall degrading enzymes)and vacuum times(5,8,11,and 14 s)after ensiling for 42 d.We found that the pathogenic Klebsiella was traced as the source of increasedα-tocopherol in rice straw silage.The residue air in the silo,pH value,and additive variety had impacts on Klebsiella activity,which was strongly active at levels of residue air in the silo and pH that were high.As an acidic niche creator,L.plantarum was more effective than sodium benzoate in restraining Klebsiella.Despite having a low acidity tolerance,Klebsiella was still present in rice straw silage treated with L.plantarum.The relationship between Klebsiella and L.plantarum was that Klebsiella could affordα-tocopherol to the multiplication of L.plantarum and residue capsular polysaccharide protected Klebsiella from escaping the extinction in rice straw silage.

Occurrence of K1 and K2 serotypes and genotypic characteristics of extended spectrumβ-lactamases-producing Klebsiella pneumoniae isolated from selected hospitals in Malaysia

Objective:To determine the distribution,phenotypic and genetic background of extended spectrumβ-lactamases(ESBL)-producing Klebsiella(K.)pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia.Methods:A total of 192 K.pneumoniae isolates were collected and subjected to antibiotic susceptibility,hypermucoviscosity test and multiplex PCR to detect the presence of K1-and K2-serotype associated genes.Multilocus sequence typing(MLST)was performed on ESBL-producing K.pneumoniae isolates presented with K1 and K2 serotypes,followed by phylogenetic analysis.Results:A total of 87 out of 192(45.3%)of the K.pneumoniae isolates collected were ESBL producers.However,only 8.3%(16/192)and 10.9%(21/192)of the total isolates were detected to carry K1-and K2-serotype associated genes,respectively.Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype(P=0.196).However,they were significantly associated with hypervirulent,as demonstrated by the positive string test(P<0.001).MLST analysis revealed that ST23 as the predominant sequence type(ST)in the K1 serotype,while the ST in the K2 serotype is more diverse.Conclusions:Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low,their coexistence warrants the need for continuous surveillance.MLST showed that these isolates were genetically heterogeneous.

Impact of Genetic Diversity of Uropathogenic Escherichia coli and Klebsiella pneumoniae Strains on the Dissemination of Extended Spectrum Beta-Lactam Resistance Genes in Côte d’Ivoire

The increase and spread of bacterial resistance to extended-spectrum beta-lactam antibiotics are reported in many infections and are a real public health problem worldwide. Drug pressure is a factor that favors the emergence of a population of better adapted bacteria. However, there is no literature highlighting the genetic diversity and evolutionary structure of E. coli and K. pneumoniae in an environment with high selection pressure in Côte d’Ivoire. The objective of this study was to evaluate the genetic diversity of E. coli and K. pneumoniae strains circulating at the HKB Hospital in Abobo and at the Daloa Regional Hospital and its impact on the dissemination of extended spectrum beta-lactam resistance genes. A total of 39 strains isolated from the urinary tract of infected patients, including 30 strains of E. coli and 9 strains of K. pneumoniae were studied. A total of 39 strains isolated from the urinary tract of infected patients, including 30 strains of E. coli and 9 strains of K. pneumoniae were studied. From genomic DNA extracts, ESBL resistance genes were amplified by PCR and sequenced, in addition to genetic typing by ERIC-PCR. The data obtained were submitted to genetic and bioinformatics analyses. The results have shown a genetic diversity important in E. coli and K. pneumoniae with diversity indexs (SID) ranging from 0.5 to 0.77. The genetic structure of the bacterial species studied has shown a clonal distribution of strains with clones expressing TEM-9 and CTX-M-15 variants. Also, this clonal structure was correlated with the spread of resistance genes in E. coli and K. pneumoniae. The spread of resistant clones is a factor that might limit the fight against antibiotic resistance.

Phenotypic Characterization of Extended Spectrum Beta-Lactamase, Class C Cephalosporinase and Carbapenemase-Producing Klebsiella Species Isolated from Patients Consulted at Four Yaounde-Based Hospitals

Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections which are often difficult to treat because of resistance to one or several antimicrobials. The aim of this study was to determine antimicrobial resistance due to Extended Spectrum Beta-lactamase (ESBL), Class C cephalosporinase (AmpC) and carbapenemase enzymes in Klebsiella spp. isolated from patients consulted at four hospitals. Methodology: The study was cross-sectional and descriptive. A total of 4190 non-repetitive patients specimens from 13 types of clinical specimens were analysed from February to November 2020. Two hundred and twenty-five (225) Klebsiella spp isolates were identified using API 20E and antimicrobial susceptibility testing done according to the Kirby Bauer disc diffusion method. ESBL and AmpC phenotypes were determined by the combination disc method and carbapenemases by double disc synergy method, referenced by EUCAST guidelines for the resistance testing. Results: The frequency of the species was Klebsiella pneumoniae (69%, 155/255), K. oxytoca (14%, 31/255), K. ozaenae (12%, 27/225) and K. rhinoscleromatis (5%, 11/225). Isolates were most resistant to sulphomethoxazole trimethoprim (84%, 189/225), cepaholosporins (80%, 180/225), and least resistant to carbapenems (10.7%, 24/225). Two K. oxytoca and one K. pneumoniae were resistant to all antibiotics tested. Klebsiella pneumoniae had the most multidrug resistant isolates (59.4%, 134/225). Most isolates (83.6%, 188/225) expressed at least one enzyme, while 63.6% (143/225) of the isolates expressed at least two enzymes. Some isolates were ESBL (71.6%, 161/225), carbapenemase (10.7%, 24/225) and AmpC (6.6%, 15/225) producers. Three carbapenemases (Klebsiella pneumoniae carbapenemase-KPC, Metallo-Beta Lactamase-MBL and OXA-48) were detected. Conclusion: These results revealed that resistance of Klebsiella spp. to cephalosporins is high and this may be exacerbated by co-expression of AmpC and carbapenemases aggravating associated patient morbidity and mortality. Monitoring of antimicrobial resistance of local strains is necessary for informed decisions on empirical treatment. .

Prevalence and Study of the Clonality of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Strains in Neonatology at the University Hospitals of Abidjan by the Pulsed Field Gel Electrophoresis and the Quantitative Antibiogram

Background: ESBL-producing strains of Klebsiella pneumoniae, one of the main causes of nosocomial and hospital-acquired infections, are commonly associated with therapeutic impasses. Surveillance of these multidrug-resistant pathogens is a crucial tool for controlling and preventing infections. This surveillance involves the use of appropriate molecular and phenotypic typing techniques. The choice of techniques is based on criteria such as discriminatory power, intra- and inter-laboratory reproducibility, epidemiological concordance, ease of use and cost. The aim of our study was to identify clusters of Extended-Spectrum Beta-Lactamase-producing Klebsiella pneumoniae (ESBL-K. pneumoniae) strains circulating in neonatology using quantitative antibiogram (QA) and Pulsed Field Gel Electrophoresis (PFGE). Materials and Methods: This cross-sectional study included 55 K. pneumoniae strains isolated from a total of 513 samples. These various samples are taken from newborns, healthcare personnel, and the environment. K. pneumoniae identification followed standard bacteriological procedures and was confirmed using the Vitek® 2 (bioMérieux). The detection of the ESBL phenotype was performed using the synergy test. QA and PFGE were used to identify clonal relationships between the various strains isolated. Concordance between these two methods was assessed by calculating Cohen’s KAPPA coefficient and Simpson’s diversity index. Results: Among the 55 K. pneumoniae strains included in this study, 58.2% (32/55) were found to be Extended-Spectrum Beta-Lactamase (ESBL) producers. Most of these strains were isolated from neonatal samples (blood samples and rectal swabs). The quantitative antibiogram method applied to 28 out of the 32 ESBL-producing strains revealed that the isolates were grouped into 5 clusters. Pulsed Field Gel Electrophoresis performed on a total of 16 ESBL-producing strains showed the existence of four profiles. A perfect concordance was observed between the two methods. Conclusion: The results of this study highlighted the existence of clonal strains of various origins within neonatology units.

Klebsiella aerogenes的胞外聚合物产量优化及其对碳酸钙晶型的调控作用

通过响应面法确定产气克雷伯氏杆菌(Klebsiella aerogenes)产胞外聚合物(EPS)的最优培养条件,并开展EPS质量浓度对Klebsiella aerogenes诱导形成碳酸钙晶型影响的试验研究。研究结果表明,相较于pH和接种量,培养时间和温度对菌株EPS产量的影响更为显著,EPS最优培养条件如下:培养时间为4.64 d、培养温度为28.35℃、接种量为2.97%、pH=7.69,在此条件下,EPS的产量可达210.24 mg/L;当添加的EPS质量浓度从0 g/L增加到1.0 g/L时,方解石的质量分数从27.1%提高至98.3%,球霰石的质量分数从72.9%下降至1.7%,表明EPS能有效促进方解石的形成并抑制球霰石的形成;EPS中带负电荷的官能团可以吸附溶液中Ca~(2+),使得溶液中Ca~(2+)浓度减小、过饱和度降低从而促进方解石型碳酸钙晶体的生成。可以通过EPS来调控Klebsiella aerogenes诱导形成方解石和球霰石的质量分数,强化碳酸钙晶体向热力学稳定的方解石型碳酸钙转化,这为提高微生物诱导碳酸钙沉淀形成的固化体的力学强度提供了新的思路。

一株大口黑鲈源ST-873型肺炎克雷伯菌(Klebsiella pneumoniae)的分离鉴定及生物学特性研究

从患腹水病大口黑鲈(Micropterus salmoides)的头肾、脾脏、肝脏组织中分离到一株优势菌,生长出圆形、边缘整齐的灰白色黏液状菌落;染色镜检可见短粗、卵圆形、有荚膜的革兰氏阴性杆菌。结合形态、生理生化特征、16S rRNA基因序列分析鉴定为肺炎克雷伯菌(Klebsiella pneumoniae),MLST分析进一步确定其为ST-873型,与ST-65型聚为一支;该菌株携带aere、alls、wca和ybt四种毒力基因,具有溶血活性;人工感染大口黑鲈,发现患病鱼呈现腹水等与自然发病类似的症状,且病鱼内脏的分离菌株与攻毒菌株相同;经统计,其LD50为3.4×10^(7) CFU/mL,具有中等生物被膜形成能力。耐药性分析结果显示,该菌株携带bla-shv、sul2、aadA和tetB四种耐药基因,对β-内酰胺类、氨基糖苷类、喹诺酮类、黏菌素类药物敏感,对四环素类、磺胺类、林可酰胺类、利福霉素类耐药;中药三七、款冬花对分离菌株有明显抑制作用。研究探明了大口黑鲈腹水病的主要病原,可为鱼源肺炎克雷伯菌的诊断和防治提供科学依据和数据参考。

Newly Detected Transmission of bla_(KPC-2) by Outer Membrane Vesicles in Klebsiella Pneumoniae

Objective The prevalence of carbapenem-resistant Klebsiella pneumoniae(CR-KP)is a global public health problem.It is mainly caused by the plasmid-carried carbapenemase gene.Outer membrane vesicles(OMVs)contain toxins and other factors involved in various biological processes,includingβ-lactamase and antibiotic-resistance genes.This study aimed to reveal the transmission mechanism of OMV-mediated drug resistance of Klebsiella(K.)pneumoniae.Methods We selected CR-KP producing K.pneumoniae carbapenemase-2(KPC-2)to study whether they can transfer resistance genes through OMVs.The OMVs of CR-KP were obtained by ultracentrifugation,and incubated with carbapenem-sensitive K.pneumoniae for 4 h.Finally,the carbapenem-sensitive K.pneumoniae was tested for the presence of bla_(KPC-2)resistance gene and its sensitivity to carbapenem antibiotics.Results The existence of OMVs was observed by the electron microscopy.The extracted OMVs had bla_(KPC-2)resistance gene.After incubation with OMVs,bla_(KPC-2)resistance gene was detected in sensitive K.pneumoniae,and it became resistant to imipenem and meropenem.Conclusion This study demonstrated that OMVs isolated from KPC-2-producing CR-KP could deliver bla_(KPC-2)to sensitive K.pneumoniae,allowing the bacteria to produce carbapenemase,which may provide a novel target for innovative therapies in combination with conventional antibiotics for treating carbapenem-resistant Enterobacteriaceae.

Successful treatment of invasive liver abscess syndrome caused by Klebsiella variicola with intracranial infection and septic shock:A case report

BACKGROUND Klebsiella variicola(K.variicola)is a member of the Klebsiella genus and is often misidentied as Klebsiella pneumoniae.In this report,we present a rare case of invasive liver abscess caused by K.variicola.CASE SUMMARY We report a rare case of liver abscess due to K.variicola.A 57-year-old female patient presented with back pain for a month.She developed a high-grade fever associated with chills,and went into a coma and developed shock.The clinical examinations and tests after admission confirmed a diagnosis of primary liver abscess caused by K.variicola complicated by intracranial infection and septic shock.The patient successfully recovered following early percutaneous drainage of the abscess,prompt appropriate antibiotic administration,and timely open surgical drainage.CONCLUSION This is a case of successful treatment of invasive liver abscess syndrome caused by K.variicola,which has rarely been reported.The findings of this report point to the need for further study of this disease.

Colonization by Klebsiella variicola FH-1 stimulates soybean growth and alleviates the stress of Sclerotinia sclerotiorum

Sclerotinia stem rot,caused by Sclerotinia sclerotiorum,is a destructive soil-borne disease leading to huge yield loss.We previously reported that Klebsiella variicola FH-1 could degrade atrazine herbicides,and the vegetative growth of atrazine-sensitive crops(i.e.,soybean)was significantly increased in the FH-1-treated soil.Interestingly,we found that FH-1 could promote soybean growth and induce resistance to S.sclerotiorum.In our study,strain FH-1 could grow in a nitrogen-free environment,dissolve inorganic phosphorus and potassium,and produce indoleacetic acid and a siderophore.The results of pot experiments showed that K.variicola FH-1 promoted soybean plant development,substantially improving plant height,fresh weight,and root length,and induced resistance against S.sclerotiorum infection in soybean leaves.The area under the disease progression curve(AUDPC)for treatment with strain FH-1 was significantly lower than the control and was reduced by up to 42.2%within 48 h(P<0.001).Moreover,strain FH-1 rcovered the activities of catalase,superoxide dismutase,peroxidase,phenylalanine ammonia lyase,and polyphenol oxidase,which are involved in plant protection,and reduced malondialdehyde accumulation in the leaves.The mechanism of induction of resistance appeared to be primarily resulted from the enhancement of transcript levels of PR10,PR12,AOS,CHS,and PDF1.2 genes.The colonization of FH-1 on soybean root,determined using CLSM and SEM,revealed that FH-1 colonized soybean root surfaces,root hairs,and exodermis to form biofilms.In summary,K.variicola FH-1 exhibited the biological control potential by inducing resistance in soybean against S.sclerotiorum infection,providing new suggestions for green prevention and control.

Atypical pompholyx presentation of secondary Staphyloccoccus and Klebsiella infections in a patient with premorbid Ebstein anomaly: A case report

Rationale: Pompholyx refers to pruritic vesicles or bullous rash that mainly distribute on the palms and lateral surfaces of the fingers. It is less common among Asians, and in a severe condition, secondary bacterial infection of pompholyx can happen and result in pain, swelling and pustules.Patient concerns: A 15-year-old girl complained of progressive wound and small bumps containing yellowish pus and crusts on her hands and feet for over 6 months and worsened in the last month before admission. She also had Ebstein anomaly.Diagnosis: Atypical pompholyx with secondary Staphylococcus and Klebsiella infections. Interventions: Wound care with wet dressing and applying moisturizer on crusts, application of antibiotics for Gram positive and negative bacteria and giving nutritional support with reckoning of proper calories. Outcomes: Skin lesions were completely healed and the patient was discharged after 10 days of hospitalization.Lessons: Atypical manifestation of pompholyx makes it hard to diagnose. The diagnosis can be confirmed with meticulous historytaking and physical examination. Wound caring and controlling of the infection should be done to earn an optimal outcome.

Nosocomial Klebsiella variicola Infection in Neonatal Intensive Care: A New Emerging Pathogen

Klebsiella variicola is a human pathogen that has been misidentified as K. pneumoniae. This misidentification has led to a lack of understanding of important clinical and biological aspects of this bacterial species. It is responsible for serious and potentially fatal infections, with a prevalence of multi-resistance to routine antibiotics. We present through three clinical observations, the case of three newborns having been hospitalized in the neonatal intensive care unit and whose evolution was complicated by the occurrence of a nosocomial infection in front of which a blood culture was done on blood agar, with a manual antibiogram on antibiotic disks, isolated the germ Klebsiella variicola. The management of the newborns was initially centered on non-invasive ventilation with a bi-antibiotic therapy based on carbapenem and amikacin for two newborns and switched to colymicin for the third case. Newborn follow-up was based on assessment of general condition, clinical signs of infection, as well as a biological control made of a blood count, a c-reactive protein, a complete ionogram, and a blood culture, every four days or if signs of clinical call. The evolution was favorable for two cases with good clinical and biological improvement, and complicated by death due to alveolar hemorrhage in the third case. Given the high pathogenicity of this germ, and the frequency of misidentification, it is crucial to know the clinical spectrum of Klebsiella variicola infections in neonatal intensive care units, in order to adapt the antibiotic therapy and to mitigate the fulminant evolution of this germ.

Resistance of Klebsiella to Imipenem by Production of Carbapenemase Gene blaIMP at Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso

Objective: Class B carbapenemases are bacterial enzymes that catalyze the hydrolysis of β-lactam core antibiotics, except for monobactams. The objective of this study was to identify the carbapenemase gene blaIMP in the genus Klebsiella at the Charles De Gaulle Pediatric University Hospital (CHUP-CDG) of Ouagadougou, Burkina Faso. Methods: The study involved 17 bacterial strains responsible for human infection and isolated from various biological samples during the period from 2009 to 2013. The strains were tested for antimicrobial susceptibility to cefotaxime, ceftazidime and imipenem using the Mueller-Hinton agar diffusion method. The carbapenemases resistance genes were detected by conventional PCR using specific primers at the molecular biology laboratory of CERBA/LABIOGENE, Ouagadougou, Burkina Faso. Results: The antibiotic susceptibility test showed high resistance of the 17 Klebsiella isolates tested to cephalosporins. A high cefotaxime-resistance rate (82.35%) and ceftazidime-resistance rate (88.23%) was found among the strains tested against 11.76% resistance rate for imipenem. Analysis of PCR products by gel electrophoresis revealed 4 strains (23.53%) with blaIMP-type gene. Conclusion: Klebsiella is a well-known bacterium in clinical practice. The present study demonstrated the blaIMP-type gene in cephalosporin-resistant strains of Klebsiella at CHUP-CDG. More effective monitoring and treatment solutions are needed to prevent the spread of these resistant strains.

Isolation and Identification Methods for Oral Klebsiella pneumoniae Involved in Onset of Inflammatory Bowel Disease

Purpose: Recently, it was reported that Klebsiella pneumoniae is related to the onset of inflammatory bowel disease including the Crohn disease. It was frequently reported that K. pneumoniae was detected in human oral cavities. Regrettably, it currently remains unclear whether K. pneumoniae is part of the normal oral flora. The aim of this study was to establish the isolation and identification methods for K. pneumoniae from human oral cavities, and investigate its transmission pattern. Methods: A selective medium, OKPSM, for the isolation of K. pneumoniae from oral cavities was developed in this study. Also, PCR primer for the identification and detection at subspecies level of K. pneumoniae was designed. Results: OKPSM and PCR method using the primers designed in this study were useful for the isolation and identification of K. pneumoniae from human oral cavities. K. pneumoniae subsp. pneumoniae was detected at 10.0% in 30 saliva samples. On the other hand, K. pneumoniae subsp. ozaenae and K. pneumoniae subsp. rhinoscleromatis were detected from no sample. Moreover, K. pneumoniae subsp. pneumoniae isolates from same subject at 0 month and after 3 months showed same genotypes on AP-PCR using OPA-07 primer. Conclusion: These results indicated that human oral cavities were not suitable for the habitat of K. pneumoniae.

Prevalence and Associated Risk Factors of Uropathogenic Klebsiella Species in Port Harcourt

Background: Urinary tract infection (UTI) is a severe public health issue that affects a wide range of people around the world with Klebsiella pneumoniae accounting for up to 25% of all urinary tract infections. The higher rate of UTI associated with uropathogenic Klebsiella species has been associated with the emergence of hypervirulent and antibiotic-resistant strains facilitated by the misuse and overuse of antibiotics as well as other sociodemographic and behavioural practices of susceptible individuals. This study was aimed at investigating the prevalence and associated risk factors of uropathogenic Klebsiella species in Port Harcourt, Nigeria. Methodology: The study employed a descriptive cross-sectional study design comprising 300 subjects clinically suspected of having urinary tract infections attending the Rivers State University Medical Centre and the Rivers State University Teaching Hospital between March to August 2022. A standard urine culture procedure was used to ascertain significant bacteriuria after which Klebsiella colonies were isolated and identified using standard bacteriological techniques. The data generated from this study was represented as frequency and percentages, and inferential statistics were carried out using Chi-square with the aid of GraphPad Prism Software Version 9. Statistical significance was defined as a p-value of less than 0.05 at a 95% confidence interval. Result: The prevalence of uropathogenic Klebsiella sp. was 16%, with sex, pregnancy status, and religion of the individuals substantially linked (p p Klebsiella species. Conclusion: This study reports a relatively high prevalence of uropathogenic Klebsiella species at 16%, with the sex and pregnancy status of the subjects being significantly associated (p Klebsiella species in the current study. Health promotion and awareness efforts should be prioritised to inform susceptible demographics about their risks for urinary tract infections associated with uropathogenic Klebsiella species via targeted educational campaigns, collaboration with healthcare providers, use of social media and online platforms, workplace wellness programs, and community outreach programs amongst others. Antimicrobial susceptibility testing before prescriptions and treatment should be emphasized and upheld in all clinical settings.