Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors
Background: Klebsiella pneumoniae (hereafter, Kp) is a major public health threat responsible for high levels of multidrug resistant (MDR) human infections. Besides, Kp also causes severe infections in the community, especially in Asia and Africa. Although most Kp infections are caused by endogenous...
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2020-09-01
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doaj-3bd0792ee758498ca3cd82adfd97c82d2021-09-20T13:17:20ZengTaylor & Francis GroupGut Microbes1949-09761949-09842020-09-011151287129910.1080/19490976.2020.17482571748257Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factorsBich-Tram Huynh0Virginie Passet1Andriniaina Rakotondrasoa2Thierno Diallo3Alexandra Kerleguer4Melanie Hennart5Agathe De Lauzanne6Perlinot Herindrainy7Abdoulaye Seck8Raymond Bercion9Laurence Borand10Maria Pardos de la Gandara11Elisabeth Delarocque-Astagneau12Didier Guillemot13Muriel Vray14Benoit Garin15Jean-Marc Collard16Carla Rodrigues17Sylvain Brisse18Pharmacoepidemiology and Infectious Diseases”(B2PhEID). Institut Pasteur, INSERM, University of Versailles Saint-QuentinInstitut PasteurInstitut Pasteur MadagascarInstitut Pasteur de DakarInstitut Pasteur du CambodgeInstitut PasteurInstitut Pasteur du CambodgeInstitut Pasteur de MadagascarInstitut Pasteur de DakarInstitut Pasteur de DakarInstitut Pasteur du CambodgeCentre National de Référence des Escherichia coli, Shigella et SalmonellaPharmacoepidemiology and Infectious Diseases”(B2PhEID). Institut Pasteur, INSERM, University of Versailles Saint-QuentinPharmacoepidemiology and Infectious Diseases”(B2PhEID). Institut Pasteur, INSERM, University of Versailles Saint-QuentinInstitut Pasteur de DakarInstitut Pasteur MadagascarInstitut Pasteur MadagascarInstitut PasteurInstitut PasteurBackground: Klebsiella pneumoniae (hereafter, Kp) is a major public health threat responsible for high levels of multidrug resistant (MDR) human infections. Besides, Kp also causes severe infections in the community, especially in Asia and Africa. Although most Kp infections are caused by endogenous intestinal carriage, little is known about the prevalence and microbiological characteristics of Kp in asymptomatic human carriage, and attached risk factors including environmental sources exposure. Methods: Here, 911 pregnant women from communities in Madagascar, Cambodia, and Senegal were screened for gut colonization by Kp. Characteristics of Kp strains (antimicrobial susceptibility, genomic diversity, virulence, and resistance genes) were defined, and associated risk factors were investigated. Results: Kp carriage rate was 55.9%, and Kp populations were highly heterogeneous (6 phylogroups, 325 sequence types, Simpson index 99.6%). One third of Kp isolates had acquired antimicrobial resistance genes. MDR-Kp (11.7% to 39.7%) and extended spectrum beta-lactamase (ESBL)-producing Kp (0.7% to 14.7%) varied among countries. Isolates with virulence genes were detected (14.5%). Environmental exposure factors including food, animal contacts, or hospitalization of household members were associated with carriage of Kp, antimicrobial resistance and hypervirulence. However, risk factors were country-specific and Kp subpopulation-specific. Conclusion: This large-scale multicenter study uncovers the huge diversity of Kp in human gut carriage, demonstrates that antimicrobial resistance is widespread in communities of three low-income countries, and underlines the challenges posed by Kp colonization to the control of antimicrobial resistance.http://dx.doi.org/10.1080/19490976.2020.1748257klebsiella pneumoniaecarriageantibiotic resistancegenomic diversitycommunitylow-income countries |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bich-Tram Huynh Virginie Passet Andriniaina Rakotondrasoa Thierno Diallo Alexandra Kerleguer Melanie Hennart Agathe De Lauzanne Perlinot Herindrainy Abdoulaye Seck Raymond Bercion Laurence Borand Maria Pardos de la Gandara Elisabeth Delarocque-Astagneau Didier Guillemot Muriel Vray Benoit Garin Jean-Marc Collard Carla Rodrigues Sylvain Brisse |
spellingShingle |
Bich-Tram Huynh Virginie Passet Andriniaina Rakotondrasoa Thierno Diallo Alexandra Kerleguer Melanie Hennart Agathe De Lauzanne Perlinot Herindrainy Abdoulaye Seck Raymond Bercion Laurence Borand Maria Pardos de la Gandara Elisabeth Delarocque-Astagneau Didier Guillemot Muriel Vray Benoit Garin Jean-Marc Collard Carla Rodrigues Sylvain Brisse Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors Gut Microbes klebsiella pneumoniae carriage antibiotic resistance genomic diversity community low-income countries |
author_facet |
Bich-Tram Huynh Virginie Passet Andriniaina Rakotondrasoa Thierno Diallo Alexandra Kerleguer Melanie Hennart Agathe De Lauzanne Perlinot Herindrainy Abdoulaye Seck Raymond Bercion Laurence Borand Maria Pardos de la Gandara Elisabeth Delarocque-Astagneau Didier Guillemot Muriel Vray Benoit Garin Jean-Marc Collard Carla Rodrigues Sylvain Brisse |
author_sort |
Bich-Tram Huynh |
title |
Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors |
title_short |
Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors |
title_full |
Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors |
title_fullStr |
Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors |
title_full_unstemmed |
Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors |
title_sort |
klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors |
publisher |
Taylor & Francis Group |
series |
Gut Microbes |
issn |
1949-0976 1949-0984 |
publishDate |
2020-09-01 |
description |
Background: Klebsiella pneumoniae (hereafter, Kp) is a major public health threat responsible for high levels of multidrug resistant (MDR) human infections. Besides, Kp also causes severe infections in the community, especially in Asia and Africa. Although most Kp infections are caused by endogenous intestinal carriage, little is known about the prevalence and microbiological characteristics of Kp in asymptomatic human carriage, and attached risk factors including environmental sources exposure. Methods: Here, 911 pregnant women from communities in Madagascar, Cambodia, and Senegal were screened for gut colonization by Kp. Characteristics of Kp strains (antimicrobial susceptibility, genomic diversity, virulence, and resistance genes) were defined, and associated risk factors were investigated. Results: Kp carriage rate was 55.9%, and Kp populations were highly heterogeneous (6 phylogroups, 325 sequence types, Simpson index 99.6%). One third of Kp isolates had acquired antimicrobial resistance genes. MDR-Kp (11.7% to 39.7%) and extended spectrum beta-lactamase (ESBL)-producing Kp (0.7% to 14.7%) varied among countries. Isolates with virulence genes were detected (14.5%). Environmental exposure factors including food, animal contacts, or hospitalization of household members were associated with carriage of Kp, antimicrobial resistance and hypervirulence. However, risk factors were country-specific and Kp subpopulation-specific. Conclusion: This large-scale multicenter study uncovers the huge diversity of Kp in human gut carriage, demonstrates that antimicrobial resistance is widespread in communities of three low-income countries, and underlines the challenges posed by Kp colonization to the control of antimicrobial resistance. |
topic |
klebsiella pneumoniae carriage antibiotic resistance genomic diversity community low-income countries |
url |
http://dx.doi.org/10.1080/19490976.2020.1748257 |
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