A Nationwide Screen of Carbapenem-Resistant Klebsiella pneumoniae Reveals an Isolate with Enhanced Virulence and Clinically Undetected Colistin Heteroresistance

Antimicrob Agents Chemother. 2019 Apr 25;63(5):e00107-19. doi: 10.1128/AAC.00107-19. Print 2019 May.

Abstract

The convergence of hypervirulence and multidrug resistance in Klebsiella pneumoniae is a significant concern. Here, we report the first screen for hypermucoviscosity, a trait associated with increased virulence, using a U.S. surveillance collection of carbapenem-resistant (CR) K. pneumoniae isolates. We identified one hypermucoviscous isolate, which carried a gene encoding the KPC-3 carbapenemase, among numerous resistance genes. The strain further exhibited colistin heteroresistance undetected by diagnostics. This convergence of diverse resistance mechanisms and increased virulence underscores the need for enhanced K. pneumoniae surveillance.

Keywords: KPC; Klebsiella; colistin; heteroresistance; hypermucoviscous.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Carbapenem-Resistant Enterobacteriaceae / drug effects
  • Carbapenem-Resistant Enterobacteriaceae / genetics*
  • Carbapenems / pharmacology*
  • Colistin / pharmacology*
  • Drug Resistance, Bacterial / genetics
  • Genotype
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / genetics
  • Microbial Sensitivity Tests
  • Virulence

Substances

  • Carbapenems
  • Colistin