Emergence of Five Genetic Lines ST395 <sup>NDM-1</sup> , ST13 <sup>OXA-48</sup> , ST3346 <sup>OXA-48</sup> , ST39 <sup>CTX-M-14</sup> , and Novel ST3551 <sup>OXA-48</sup> of Multidrug-Resistant Clinical <i>Klebsiella pneumoniae</i> in Russia
Nadezhda K. Fursova, Evgeny I. Astashkin, N. I. Gabrielyan, Tatiana S. Novikova, G. N. Fedyukina, Madina Kh. Kubanova, Nadezhda M. Esenova, С. О. Шарапченко, Nikolay V. Volozhantsev
Abstract
Aims: The objective of this study was phenotypic and genotypic characterization of antibacterial-resistant Klebsiella pneumoniae clinical strains isolated in Moscow Transplantology Intensive Care Unit in 2017–2019. R esults: Major strains among K. pneumoniae ( n = 63) isolated from 30 patients were recognized as extensive drug-resistant ( n = 55) pathogens, and remaining strains were recognized as multidrug-resistant ( n = 8) pathogens. The beta-lactamase genes bla SHV-1,-2a,-11,-27,-67,-187 ( n = 63), bla CTX-M-14,-15 ( n = 61), bla TEM-1 ( n = 54), bla OXA-48 ( n = 52), and bla NDM-1 ( n = 2), as well as class 1 integrons ( n = 19) carried gene cassette arrays aac A4 ( n = 2), dfr A1 -orf C ( n = 6), aad B -aad A1 ( n = 9), dfr A15 -aad A1 ( n = 3), and dfr A12 -orfF-aadA2 ( n = 1) were identified in the strains. All strains carried four virulence genes: wab G, fim H, uge , and all S, but two strains had additionally kfu gene. Six known sequence types (STs) of K. pneumoniae ST395 ( n = 44), ST377 ( n = 3), ST307 ( n = 4), ST13 ( n = 2), ST39 ( n = 2), ST3346 ( n = 1), and a novel sequence-type ST3551 ( n = 7) were identified. Phylogenetic analysis showed that ST3551 belonged to the cluster of clonal group CG147, and the remaining six STs to the another cluster consisting of four subgroups. The emergence of K. pneumoniae genetic lines carrying epidemiologically significant beta-lactamase genes ST395 NDM-1 , ST13 OXA-48 , ST3346 OXA-48/CTX-M-14 , ST3551 OXA-48 , and ST39 CTX-M-14 was the first case of detection in Russia. Conclusion: The emergence of novel carbapenemase-producing K. pneumoniae genetic lines in Russia highlights the global negative tendency of multidrug-resistant pathogens spread in high-technological medical centers.