Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, Bangladesh

Background: 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. Objective: We aimed to define the clinical characteristics of a cohort of patients with Kpn infection...

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Main Authors: Zannat Kawser, Sushmita Sridhar, Sanchita Kar, Tanbir Habib, Sharmin Akter Mukta, Kasrina Azad, Neyamul Hasan, Umme Kulsum, Abu Bakar Siddik, Saikt Rahman, Nusrat Noor Tanni, Maherun Nesa, Ashlee M. Earl, Colin J. Worby, Sarah E. Turbett, SM Shamsuzzaman, Jason B Harris, Firdausi Qadri, Regina C LaRocque
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524004831
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Summary:Background: 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. Objective: 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. Methods: 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. Results: 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. Conclusion: Our findings suggest alarming levels of AMR among Kpn isolates in Bangladesh and a critical need for improved treatment modalities and vaccine development.
ISSN:2213-7165