Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe

Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Anouk J. M. M. Braspenning [verfasserIn] Sahaya Glingston Rajakani [verfasserIn] Adwoa Sey [verfasserIn] Mariem El Bounja [verfasserIn] Christine Lammens [verfasserIn] Youri Glupczynski [verfasserIn] Surbhi Malhotra-Kumar [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2024

Schlagwörter:	colistin resistance mechanisms mgrB population analysis profiling whole-genome sequencing

Übergeordnetes Werk:	In: Antibiotics - MDPI AG, 2013, 13(2024), 3, p 281
Übergeordnetes Werk:	volume:13 ; year:2024 ; number:3, p 281

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/antibiotics13030281

Katalog-ID:	DOAJ100882528

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520			\|a Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens.
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allfields	10.3390/antibiotics13030281 doi (DE-627)DOAJ100882528 (DE-599)DOAJ7310b34ebc3b4a29905935fe844a51ab DE-627 ger DE-627 rakwb eng RM1-950 Anouk J. M. M. Braspenning verfasserin aut Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens. colistin resistance mechanisms mgrB population analysis profiling whole-genome sequencing Therapeutics. Pharmacology Sahaya Glingston Rajakani verfasserin aut Adwoa Sey verfasserin aut Mariem El Bounja verfasserin aut Christine Lammens verfasserin aut Youri Glupczynski verfasserin aut Surbhi Malhotra-Kumar verfasserin aut In Antibiotics MDPI AG, 2013 13(2024), 3, p 281 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:13 year:2024 number:3, p 281 https://doi.org/10.3390/antibiotics13030281 kostenfrei https://doaj.org/article/7310b34ebc3b4a29905935fe844a51ab kostenfrei https://www.mdpi.com/2079-6382/13/3/281 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2024 3, p 281
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allfields_unstemmed	10.3390/antibiotics13030281 doi (DE-627)DOAJ100882528 (DE-599)DOAJ7310b34ebc3b4a29905935fe844a51ab DE-627 ger DE-627 rakwb eng RM1-950 Anouk J. M. M. Braspenning verfasserin aut Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens. colistin resistance mechanisms mgrB population analysis profiling whole-genome sequencing Therapeutics. Pharmacology Sahaya Glingston Rajakani verfasserin aut Adwoa Sey verfasserin aut Mariem El Bounja verfasserin aut Christine Lammens verfasserin aut Youri Glupczynski verfasserin aut Surbhi Malhotra-Kumar verfasserin aut In Antibiotics MDPI AG, 2013 13(2024), 3, p 281 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:13 year:2024 number:3, p 281 https://doi.org/10.3390/antibiotics13030281 kostenfrei https://doaj.org/article/7310b34ebc3b4a29905935fe844a51ab kostenfrei https://www.mdpi.com/2079-6382/13/3/281 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2024 3, p 281
allfieldsGer	10.3390/antibiotics13030281 doi (DE-627)DOAJ100882528 (DE-599)DOAJ7310b34ebc3b4a29905935fe844a51ab DE-627 ger DE-627 rakwb eng RM1-950 Anouk J. M. M. Braspenning verfasserin aut Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens. colistin resistance mechanisms mgrB population analysis profiling whole-genome sequencing Therapeutics. Pharmacology Sahaya Glingston Rajakani verfasserin aut Adwoa Sey verfasserin aut Mariem El Bounja verfasserin aut Christine Lammens verfasserin aut Youri Glupczynski verfasserin aut Surbhi Malhotra-Kumar verfasserin aut In Antibiotics MDPI AG, 2013 13(2024), 3, p 281 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:13 year:2024 number:3, p 281 https://doi.org/10.3390/antibiotics13030281 kostenfrei https://doaj.org/article/7310b34ebc3b4a29905935fe844a51ab kostenfrei https://www.mdpi.com/2079-6382/13/3/281 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2024 3, p 281
allfieldsSound	10.3390/antibiotics13030281 doi (DE-627)DOAJ100882528 (DE-599)DOAJ7310b34ebc3b4a29905935fe844a51ab DE-627 ger DE-627 rakwb eng RM1-950 Anouk J. M. M. Braspenning verfasserin aut Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens. colistin resistance mechanisms mgrB population analysis profiling whole-genome sequencing Therapeutics. Pharmacology Sahaya Glingston Rajakani verfasserin aut Adwoa Sey verfasserin aut Mariem El Bounja verfasserin aut Christine Lammens verfasserin aut Youri Glupczynski verfasserin aut Surbhi Malhotra-Kumar verfasserin aut In Antibiotics MDPI AG, 2013 13(2024), 3, p 281 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:13 year:2024 number:3, p 281 https://doi.org/10.3390/antibiotics13030281 kostenfrei https://doaj.org/article/7310b34ebc3b4a29905935fe844a51ab kostenfrei https://www.mdpi.com/2079-6382/13/3/281 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2024 3, p 281
language	English
source	In Antibiotics 13(2024), 3, p 281 volume:13 year:2024 number:3, p 281
sourceStr	In Antibiotics 13(2024), 3, p 281 volume:13 year:2024 number:3, p 281
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	colistin resistance mechanisms mgrB population analysis profiling whole-genome sequencing Therapeutics. Pharmacology
isfreeaccess_bool	true
container_title	Antibiotics
authorswithroles_txt_mv	Anouk J. M. M. Braspenning @@aut@@ Sahaya Glingston Rajakani @@aut@@ Adwoa Sey @@aut@@ Mariem El Bounja @@aut@@ Christine Lammens @@aut@@ Youri Glupczynski @@aut@@ Surbhi Malhotra-Kumar @@aut@@
publishDateDaySort_date	2024-01-01T00:00:00Z
hierarchy_top_id	726120596
id	DOAJ100882528
language_de	englisch
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callnumber-first	R - Medicine
author	Anouk J. M. M. Braspenning
spellingShingle	Anouk J. M. M. Braspenning misc RM1-950 misc colistin resistance misc mechanisms misc mgrB misc population analysis profiling misc whole-genome sequencing misc Therapeutics. Pharmacology Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe
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topic_title	RM1-950 Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe colistin resistance mechanisms mgrB population analysis profiling whole-genome sequencing
topic	misc RM1-950 misc colistin resistance misc mechanisms misc mgrB misc population analysis profiling misc whole-genome sequencing misc Therapeutics. Pharmacology
topic_unstemmed	misc RM1-950 misc colistin resistance misc mechanisms misc mgrB misc population analysis profiling misc whole-genome sequencing misc Therapeutics. Pharmacology
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title	Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe
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title_full	Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe
author_sort	Anouk J. M. M. Braspenning
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author_browse	Anouk J. M. M. Braspenning Sahaya Glingston Rajakani Adwoa Sey Mariem El Bounja Christine Lammens Youri Glupczynski Surbhi Malhotra-Kumar
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title_sort	assessment of colistin heteroresistance among multidrug-resistant <i<klebsiella pneumoniae</i< isolated from intensive care patients in europe
callnumber	RM1-950
title_auth	Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe
abstract	Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens.
abstractGer	Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens.
abstract_unstemmed	Heteroresistance (HR) to colistin is especially concerning in settings where multi-drug-resistant (MDR) <i<K. pneumoniae</i< are prevalent and empiric use of colistin might lead to treatment failures. This study aimed to assess the frequency of occurrence of colistin HR (CHR) among (MDR) <i<K. pneumoniae</i< (<i<n</i< = 676) isolated from patients hospitalized in 13 intensive care units (ICUs) in six European countries in a clinical trial assessing the impact of decolonization strategies. All isolates were whole-genome-sequenced and studied for in vitro colistin susceptibility. The majority were colistin-susceptible (CS) (<i<n</i< = 597, MIC ≤ 2 µg/mL), and 79 were fully colistin-resistant (CR) (MIC < 2 µg/mL). A total of 288 CS isolates were randomly selected for population analysis profiling (PAP) to assess CHR prevalence. CHR was detected in 108/288 CS <i<K. pneumoniae</i<. No significant association was found between the occurrence of CHR and country, MIC-value, K-antigen type, and O-antigen type. Overall, 92% (617/671) of the <i<K. pneumoniae</i< were MDR with high prevalence among CS (91%, 539/592) and CR (98.7%, 78/79) isolates. In contrast, the proportion of carbapenemase-producing <i<K. pneumoniae</i< (CP-Kpn) was higher among CR (72.2%, 57/79) than CS isolates (29.3%, 174/594). The proportions of MDR and CP-Kpn were similar among CHR (MDR: 85%, 91/107; CP-Kpn: 29.9%, 32/107) and selected CS isolates (MDR: 84.7%, 244/288; CP-Kpn: 28.1%, 80/285). WGS analysis of PAP isolates showed diverse insertion elements in <i<mgrB</i< or even among technical replicates underscoring the stochasticity of the CHR phenotype. CHR isolates showed high sequence type (ST) diversity (Simpson’s diversity index, SDI: 0.97, in 52 of the 85 STs tested). CR (SDI: 0.85) isolates were highly associated with specific STs (ST101, ST147, ST258/ST512, <i<p</i< ≤ 0.003). The widespread nature of CHR among MDR <i<K. pneumoniae</i< in our study urge the development of rapid HR detection methods to inform on the need for combination regimens.
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title_short	Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe
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Assessment of Colistin Heteroresistance among Multidrug-Resistant <i<Klebsiella pneumoniae</i< Isolated from Intensive Care Patients in Europe

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