Klebsiella pneumoniae with carbapenemases: high prevalence of sequence type 307 with blaOXA181 in South African community hospitals

Kafilat Taiwo Salvador-Oke; Johann D D Pitout; Gisele Peirano; Kathy-Anne Strydom; Chanel Kingsburgh; Marthie M Ehlers; Marleen M Kock

doi:10.1007/s10096-024-04947-z

Klebsiella pneumoniae with carbapenemases: high prevalence of sequence type 307 with bla_OXA181 in South African community hospitals

Eur J Clin Microbiol Infect Dis. 2024 Nov;43(11):2239-2244. doi: 10.1007/s10096-024-04947-z. Epub 2024 Sep 17.

Authors

Kafilat Taiwo Salvador-Oke¹, Johann D D Pitout^{1

2

3}, Gisele Peirano^{2

3}, Kathy-Anne Strydom^{4

5}, Chanel Kingsburgh^{4

5}, Marthie M Ehlers^{1

4}, Marleen M Kock^{6

7}

Affiliations

¹ Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
² Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada.
³ Alberta Precision Laboratories, Calgary, Canada.
⁴ Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa.
⁵ Ampath National Reference Laboratory, Centurion, Pretoria, South Africa.
⁶ Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. [email protected].
⁷ Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa. [email protected].

Abstract

This study investigated the molecular characteristics of urinary carbapenemase-producing Klebsiella pneumoniae isolates (n = 194) in Gauteng, South Africa, using simple, cost-effective PCR methodologies. Extensively drug resistant (XDR) ST307 with bla_OXA-181 on IncX3 plasmids was endemic in Gauteng community hospitals leaving limited options for treating in- and outpatient urinary tract infections. High-level ceftazidime/avibactam resistance was detected among isolates harbouring bla_OXA-48-like including bla_OXA-181. These findings highlighted the need for genomic methodologies suitable for lower- and middle-income countries to track XDR clones and plasmids in community hospitals. Such results will aid with treatment and stewardship strategies.

Keywords: bla OXA-181; Carbapenemase-producing Klebsiella pneumoniae; High-risk clone ST307; IncX3 plasmid; Lower and middle-Income countries.

MeSH terms

Anti-Bacterial Agents* / pharmacology
Anti-Bacterial Agents* / therapeutic use
Azabicyclo Compounds / pharmacology
Bacterial Proteins* / genetics
Ceftazidime / pharmacology
Ceftazidime / therapeutic use
Drug Resistance, Multiple, Bacterial / genetics
Hospitals, Community*
Humans
Klebsiella Infections* / drug therapy
Klebsiella Infections* / epidemiology
Klebsiella Infections* / microbiology
Klebsiella pneumoniae* / drug effects
Klebsiella pneumoniae* / enzymology
Klebsiella pneumoniae* / genetics
Microbial Sensitivity Tests
Plasmids / genetics
Prevalence
South Africa / epidemiology
Urinary Tract Infections / drug therapy
Urinary Tract Infections / epidemiology
Urinary Tract Infections / microbiology
beta-Lactamases* / genetics

Substances

beta-Lactamases
carbapenemase
Bacterial Proteins
Anti-Bacterial Agents
Ceftazidime
Azabicyclo Compounds

Grants and funding

129376/National Research Foundation