IJID regions · 2026
Genomics of multidrug-resistant Klebsiella pneumoniae isolates from community hospitals in Pretoria, South Africa.
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Mohlamoyane Mokawane Victor, Pitout Johann David Daniel, Lentswe Tshepiso Innocent, Liknaitzky Sarah, Salvador-Oke Kafilat Taiwo, Moultrie Andrew, Moodley Mishalan, Featherston Jonathan, Smith Anthony Marius, Ismail Arshad, Said Mohamed, Ehlers Marthie Magdaleen, Kock Marleen Martha
Аннотация
OBJECTIVES: Multidrug-resistant (MDR) Klebsiella pneumoniae high-risk clones that produce carbapenemases and extended-spectrum β-lactamases (ESBLs) are a major public health threat, limiting treatment options. This study aimed to determine the prevalence, clonal diversity, and molecular characteristics of MDR carbapenemase-producing Klebsiella pneumoniae (CPKP) and ESBL-producing Klebsiella pneumoniae isolates from community hospitals in Pretoria, South Africa.
METHODS: Whole genome sequencing and polymerase chain reaction assays were used to characterize sequence types, resistance genes, and selected mobile genetic elements.
RESULTS: The bla OXA-48-like gene was the most detected carbapenemase gene, followed by bla NDM, bla KPC, and bla VIM. The prevalence of sequence type (ST) 307 was 34.7% (41 of 118) and 29.4% (10 of 34) in CPKP and ESBL-producing K. pneumoniae, respectively. Double-carbapenemase-producing K. pneumoniae clones included ST307 with bla NDM-1 + bla OXA-181, ST530 and ST2680 with bla KPC-2 + bla OXA-181, and pandrug-resistant ST2497 carrying bla NDM-1 + bla OXA-232. One ST17 isolate and one pandrug-resistant ST307 isolate harbored three carbapenemase genes (bla KPC + bla NDM + bla OXA-48-like).
CONCLUSION: The emergence and spread of new MDR K. pneumoniae high-risk clones with multiple carbapenemases in resource-constrained South African hospitals are a great concern due to limited treatment options. These findings call for urgent epidemiologic surveillance and enhanced infection prevention and control measures.
METHODS: Whole genome sequencing and polymerase chain reaction assays were used to characterize sequence types, resistance genes, and selected mobile genetic elements.
RESULTS: The bla OXA-48-like gene was the most detected carbapenemase gene, followed by bla NDM, bla KPC, and bla VIM. The prevalence of sequence type (ST) 307 was 34.7% (41 of 118) and 29.4% (10 of 34) in CPKP and ESBL-producing K. pneumoniae, respectively. Double-carbapenemase-producing K. pneumoniae clones included ST307 with bla NDM-1 + bla OXA-181, ST530 and ST2680 with bla KPC-2 + bla OXA-181, and pandrug-resistant ST2497 carrying bla NDM-1 + bla OXA-232. One ST17 isolate and one pandrug-resistant ST307 isolate harbored three carbapenemase genes (bla KPC + bla NDM + bla OXA-48-like).
CONCLUSION: The emergence and spread of new MDR K. pneumoniae high-risk clones with multiple carbapenemases in resource-constrained South African hospitals are a great concern due to limited treatment options. These findings call for urgent epidemiologic surveillance and enhanced infection prevention and control measures.