Molecular Characterization of Multidrug-Resistant and Hypervirulent New Delhi Metallo-Beta-Lactamase <i>Klebsiella pneumoniae</i> in Lazio, Italy: A Five-Year Retrospective Study
Background/Objectives: Antimicrobial resistance represents a challenge to public health systems because of the array of resistance and virulence mechanisms that lead to treatment failure and increased mortality rates. Although for years the main driver of carbapenem resistance in Italy has been the...
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2024-11-01
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| author | Claudia Rotondo Carolina Venditti Ornella Butera Valentina Dimartino Francesco Messina Michele Properzi Claudia Caparrelli Valentina Antonelli Silvia D’Arezzo Marina Selleri Carla Nisii Carla Fontana on behalf of the Lazio Region Laboratory Study Group |
| author_facet | Claudia Rotondo Carolina Venditti Ornella Butera Valentina Dimartino Francesco Messina Michele Properzi Claudia Caparrelli Valentina Antonelli Silvia D’Arezzo Marina Selleri Carla Nisii Carla Fontana on behalf of the Lazio Region Laboratory Study Group |
| author_sort | Claudia Rotondo |
| collection | DOAJ |
| description | Background/Objectives: Antimicrobial resistance represents a challenge to public health systems because of the array of resistance and virulence mechanisms that lead to treatment failure and increased mortality rates. Although for years the main driver of carbapenem resistance in Italy has been the <i>Klebsiella pneumoniae</i> KPC carbapenemase, recent years have seen an increase in VIM and NDM metallo-beta-lactamases (MBLs). We conducted a five-year survey of New Delhi Metallo-beta-Lactamase (NDM)-producing <i>Klebsiella pneumoniae</i> (NDM-Kpn) clinical isolates from the Lazio region, Italy; the study aimed to elucidate the molecular mechanisms underpinning their resistant and virulent phenotype. Methods: Antimicrobial susceptibility was evaluated by automated systems and broth microdilution. In silico analysis of acquired resistance and virulence genes was performed using whole-genome sequencing (WGS), molecular typing through MLST, and core genome multi-locus sequence typing (cgMLST). Conclusions: A total of 126 clinical NDM-Kpn isolates were collected from 19 distinct hospitals in the Lazio region. Molecular analysis highlighted the existence of NDM-1 (108/126) and NDM-5 (18/126) variants, 18 Sequence Types (STs), and 15 Cluster Types (CTs). Notably, 31/126 isolates displayed a virulence score of 4, carrying <i>ybt</i>, <i>ICEKp</i>, <i>iuc</i>, and <i>rmp</i> genes. This study identified a variety of NDM-Kpn STs, mainly carrying the <i>bla</i><sub>NDM-1</sub> gene, with a significant number linked to high-risk clones. Of these isolates, 24.6% showed high-level resistance and virulence, emphasizing the risk of the spread of strains that combine multi-drug-resistance (MDR) and virulence. Proactive surveillance and international collaborations are needed to prevent the spread of high-risk clones, as well as further research into new antimicrobial agents to fight antibiotic resistance. |
| format | Article |
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| language | English |
| publishDate | 2024-11-01 |
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| spelling | doaj-art-0dbdb301390e4ce6ac3bdf3f9b8ef9ae2025-08-20T02:26:47ZengMDPI AGAntibiotics2079-63822024-11-011311104510.3390/antibiotics13111045Molecular Characterization of Multidrug-Resistant and Hypervirulent New Delhi Metallo-Beta-Lactamase <i>Klebsiella pneumoniae</i> in Lazio, Italy: A Five-Year Retrospective StudyClaudia Rotondo0Carolina Venditti1Ornella Butera2Valentina Dimartino3Francesco Messina4Michele Properzi5Claudia Caparrelli6Valentina Antonelli7Silvia D’Arezzo8Marina Selleri9Carla Nisii10Carla Fontana11on behalf of the Lazio Region Laboratory Study Group12National Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyNational Institute for Infectious Diseases “L. Spallanzani” Istituto di Ricovero e Cura a Carattere Scientifico, via Portuense 292, 00149 Rome, ItalyBackground/Objectives: Antimicrobial resistance represents a challenge to public health systems because of the array of resistance and virulence mechanisms that lead to treatment failure and increased mortality rates. Although for years the main driver of carbapenem resistance in Italy has been the <i>Klebsiella pneumoniae</i> KPC carbapenemase, recent years have seen an increase in VIM and NDM metallo-beta-lactamases (MBLs). We conducted a five-year survey of New Delhi Metallo-beta-Lactamase (NDM)-producing <i>Klebsiella pneumoniae</i> (NDM-Kpn) clinical isolates from the Lazio region, Italy; the study aimed to elucidate the molecular mechanisms underpinning their resistant and virulent phenotype. Methods: Antimicrobial susceptibility was evaluated by automated systems and broth microdilution. In silico analysis of acquired resistance and virulence genes was performed using whole-genome sequencing (WGS), molecular typing through MLST, and core genome multi-locus sequence typing (cgMLST). Conclusions: A total of 126 clinical NDM-Kpn isolates were collected from 19 distinct hospitals in the Lazio region. Molecular analysis highlighted the existence of NDM-1 (108/126) and NDM-5 (18/126) variants, 18 Sequence Types (STs), and 15 Cluster Types (CTs). Notably, 31/126 isolates displayed a virulence score of 4, carrying <i>ybt</i>, <i>ICEKp</i>, <i>iuc</i>, and <i>rmp</i> genes. This study identified a variety of NDM-Kpn STs, mainly carrying the <i>bla</i><sub>NDM-1</sub> gene, with a significant number linked to high-risk clones. Of these isolates, 24.6% showed high-level resistance and virulence, emphasizing the risk of the spread of strains that combine multi-drug-resistance (MDR) and virulence. Proactive surveillance and international collaborations are needed to prevent the spread of high-risk clones, as well as further research into new antimicrobial agents to fight antibiotic resistance.https://www.mdpi.com/2079-6382/13/11/1045carbapenem-resistant<i>klebsiella pneumoniae</i>molecular typingNDMvirulence geneswhole-genome sequencing |
| spellingShingle | Claudia Rotondo Carolina Venditti Ornella Butera Valentina Dimartino Francesco Messina Michele Properzi Claudia Caparrelli Valentina Antonelli Silvia D’Arezzo Marina Selleri Carla Nisii Carla Fontana on behalf of the Lazio Region Laboratory Study Group Molecular Characterization of Multidrug-Resistant and Hypervirulent New Delhi Metallo-Beta-Lactamase <i>Klebsiella pneumoniae</i> in Lazio, Italy: A Five-Year Retrospective Study Antibiotics carbapenem-resistant <i>klebsiella pneumoniae</i> molecular typing NDM virulence genes whole-genome sequencing |
| title | Molecular Characterization of Multidrug-Resistant and Hypervirulent New Delhi Metallo-Beta-Lactamase <i>Klebsiella pneumoniae</i> in Lazio, Italy: A Five-Year Retrospective Study |
| title_full | Molecular Characterization of Multidrug-Resistant and Hypervirulent New Delhi Metallo-Beta-Lactamase <i>Klebsiella pneumoniae</i> in Lazio, Italy: A Five-Year Retrospective Study |
| title_fullStr | Molecular Characterization of Multidrug-Resistant and Hypervirulent New Delhi Metallo-Beta-Lactamase <i>Klebsiella pneumoniae</i> in Lazio, Italy: A Five-Year Retrospective Study |
| title_full_unstemmed | Molecular Characterization of Multidrug-Resistant and Hypervirulent New Delhi Metallo-Beta-Lactamase <i>Klebsiella pneumoniae</i> in Lazio, Italy: A Five-Year Retrospective Study |
| title_short | Molecular Characterization of Multidrug-Resistant and Hypervirulent New Delhi Metallo-Beta-Lactamase <i>Klebsiella pneumoniae</i> in Lazio, Italy: A Five-Year Retrospective Study |
| title_sort | molecular characterization of multidrug resistant and hypervirulent new delhi metallo beta lactamase i klebsiella pneumoniae i in lazio italy a five year retrospective study |
| topic | carbapenem-resistant <i>klebsiella pneumoniae</i> molecular typing NDM virulence genes whole-genome sequencing |
| url | https://www.mdpi.com/2079-6382/13/11/1045 |
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