Kawser Zannat, Sridhar Sushmita, Kar Sanchita, Habib Tanbir, Mukta Sharmin Akter, Azad Kasrina, Hasan Neyamul, Kulsum Umme, Siddik Abu Bakar, Rahman Saikt, Tanni Nusrat Noor, Nesa Maherun, Earl Ashlee M, Worby Colin J, Turbett Sarah E, Shamsuzzaman S M, Harris Jason B, Qadri Firdausi, LaRocque Regina C
institute for developing Science and Health initiatives, Dhaka, Bangladesh.
Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA USA.
J Glob Antimicrob Resist. 2025 Mar;41:52-58. doi: 10.1016/j.jgar.2024.12.016. Epub 2024 Dec 24.
Klebsiella pneumoniae (Kpn), a WHO priority pathogen with high rates of antimicrobial resistance (AMR), has emerged as a leading cause of hospital acquired pneumonia and neonatal sepsis.
We aimed to define the clinical characteristics of a cohort of patients with Kpn infection in Dhaka, Bangladesh and to perform phenotypic and genetic characterization of the associated isolates.
We retrospectively extracted clinical data about patients at Dhaka Medical College Hospital from whom Klebsiella spp was isolated from a clinical specimen collected between February and September 2022. We used standard microbiologic techniques to evaluate AMR and whole-genome sequencing (WGS) to assess dominant lineages, common capsular (K) and O-polysaccharide (O) antigen types, and AMR and virulence genes.
Ninety-eight patients were included, with diagnoses of pneumonia (38/98, 39 %), wound infection (29/98, 31 %), urinary tract infection (29/98, 31 %) and bacteremia (2/98, 2 %). We tested isolates for susceptibility to eight classes of antibiotics. Of the 98 isolates, 41 % were multidrug resistant (MDR), 15 % were extensively drug resistant (XDR), and 16 % were pan-drug resistant (PDR). Three isolates (3 %) were resistant to polymyxin B. Outcome data were available for 46 patients; 4 patients (8 %) died from infections caused by PDR (n = 2), XDR (n = 1), and MDR isolates (n = 1). WGS revealed a high degree of genomic diversity, with multiple sequence types (STs), O-types and K-types represented; ST16:K81:OL101 and ST43:K30:O1 were the most prevalent.
Our findings suggest alarming levels of AMR among Kpn isolates in Bangladesh and a critical need for improved treatment modalities and vaccine development.
肺炎克雷伯菌（Kpn）是世界卫生组织认定的重点病原体，耐药率高，已成为医院获得性肺炎和新生儿败血症的主要病因。
我们旨在明确孟加拉国达卡一组肺炎克雷伯菌感染患者的临床特征，并对相关分离株进行表型和基因特征分析。
我们回顾性提取了达卡医学院医院2022年2月至9月期间从临床标本中分离出克雷伯菌属的患者的临床数据。我们使用标准微生物学技术评估耐药性，并采用全基因组测序（WGS）来评估优势菌系、常见荚膜（K）和O-多糖（O）抗原类型以及耐药和毒力基因。
纳入98例患者，诊断包括肺炎（38/98，39%）、伤口感染（29/98，31%）、尿路感染（29/98，31%）和菌血症（2/98，2%）。我们检测了分离株对八类抗生素的敏感性。98株分离株中，41%为多重耐药（MDR），15%为广泛耐药（XDR），16%为泛耐药（PDR）。3株（3%）对多粘菌素B耐药。46例患者有结局数据；4例患者（8%）死于由PDR（n = 2）、XDR（n = 1）和MDR分离株（n = 1）引起的感染。WGS显示出高度的基因组多样性，存在多种序列类型（STs）、O型和K型；ST16:K81:OL101和ST43:K30:O1最为常见。
我们的研究结果表明孟加拉国肺炎克雷伯菌分离株的耐药水平令人担忧，迫切需要改进治疗方法和开发疫苗。
