Nicholas Agyepong1, Usha Govinden2, Alex Owusu-Ofori3, Daniel Gyamfi Amoako4, Mushal Allam5, Jessin Janice6, Torunn Pedersen6, Arnfinn Sundsfjord7, Sabiha Essack2. 1. Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. Electronic address: agyanicho33@yahoo.com. 2. Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. 3. School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 4. Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Infection Genomics and Applied Bioinformatics Division, Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. 5. Sequencing Core Facility, National Institute for Communicable Disease, National Health Laboratory Service, South Africa. 6. Norwegian National Advisory Unit on Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromso, Norway. 7. Norwegian National Advisory Unit on Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromso, Norway; Department of Medical Biology, Faculty of Health Sciences, UiT - The Arctic University of Norway, Norway.
Abstract
OBJECTIVES: This study delineated the clonal lineages, antibiotic resistome and plasmid replicon types in multidrug-resistant K. pneumoniae isolates from a teaching hospital in Ghana. METHODS: Identification and antibiotic susceptibility testing were done using the MALDI-TOF MS and Vitek-2 automated system. Genomic DNA extraction was carried out using the NucliSens easyMAG® (BioMérieux) kits and the DNA was subjected to whole genome sequencing (WGS) using the Illumina MiSeq platform. RESULTS: Of the 200 isolates obtained, 37 were identified as K. pneumoniae of which 9 were resistant to all second and third-generation cephalosporins. These 9 isolates selected for further genomic analysis were characterized by the presence of 8 diverse sequence types (STs), capsular polysaccharide serotypes (K types and wzi allelic types) and multiple genes encoding resistance to β-lactams (blaCTX-M-15, blaSHV-11,blaTEM-1B,blaOXA-1), aminoglycosides (aac(3)-IIa, strB, strA, aadA16), fluoroquinolones/quinolones (qnrB66, oqxA, oqxB) and other antibiotic classes. Resistance genes were associated with plasmids, predominantly IncFIB(K) and ColRNAI. Multiple and diverse mutations in quinolone resistance-determining regions of gyrA (S83Y, D87A) and parC (S80I, N304S) in isolates resistant to ciprofloxacin (MIC ≥ 4 mg/mL) were found. Global phylogenomic analysis affirmed the diverse clonal clustering and origin of these isolates. CONCLUSIONS: The varied clonal clusters and resistome identified in the multidrug-resistant K. pneumoniae isolates is a major threat to the management of infections in Ghana. The molecular characterization of antibiotic resistance is thus imperative to inform strategies for containment.
OBJECTIVES: This study delineated the clonal lineages, antibiotic resistome and plasmid replicon types in multidrug-resistant K. pneumoniae isolates from a teaching hospital in Ghana. METHODS: Identification and antibiotic susceptibility testing were done using the MALDI-TOF MS and Vitek-2 automated system. Genomic DNA extraction was carried out using the NucliSens easyMAG® (BioMérieux) kits and the DNA was subjected to whole genome sequencing (WGS) using the Illumina MiSeq platform. RESULTS: Of the 200 isolates obtained, 37 were identified as K. pneumoniae of which 9 were resistant to all second and third-generation cephalosporins. These 9 isolates selected for further genomic analysis were characterized by the presence of 8 diverse sequence types (STs), capsular polysaccharide serotypes (K types and wzi allelic types) and multiple genes encoding resistance to β-lactams (blaCTX-M-15, blaSHV-11,blaTEM-1B,blaOXA-1), aminoglycosides (aac(3)-IIa, strB, strA, aadA16), fluoroquinolones/quinolones (qnrB66, oqxA, oqxB) and other antibiotic classes. Resistance genes were associated with plasmids, predominantly IncFIB(K) and ColRNAI. Multiple and diverse mutations in quinolone resistance-determining regions of gyrA (S83Y, D87A) and parC (S80I, N304S) in isolates resistant to ciprofloxacin (MIC ≥ 4 mg/mL) were found. Global phylogenomic analysis affirmed the diverse clonal clustering and origin of these isolates. CONCLUSIONS: The varied clonal clusters and resistome identified in the multidrug-resistant K. pneumoniae isolates is a major threat to the management of infections in Ghana. The molecular characterization of antibiotic resistance is thus imperative to inform strategies for containment.
Authors: Celia C Carlos; Melissa Ana L Masim; Marietta L Lagrada; June M Gayeta; Polle Krystle V Macaranas; Sonia B Sia; Maria Adelina M Facun; Janziel Fiel C Palarca; Agnettah M Olorosa; Gicell Anne C Cueno; Monica Abrudan; Khalil Abudahab; Silvia Argimón; Mihir Kekre; Anthony Underwood; John Stelling; David M Aanensen Journal: Clin Infect Dis Date: 2021-12-01 Impact factor: 9.079
Authors: Yogandree Ramsamy; Koleka P Mlisana; Mushal Allam; Daniel G Amoako; Akebe L K Abia; Arshad Ismail; Ravesh Singh; Theroshnie Kisten; Khine Swe Han; David J Jackson Muckart; Timothy Hardcastle; Moosa Suleman; Sabiha Y Essack Journal: Microorganisms Date: 2020-01-17