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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author 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
author_facet 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
author_sort Zannat Kawser
collection DOAJ
description 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.
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spelling doaj-art-e96702cd19c041a5826333fafba0b7d32025-08-20T01:57:36ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-03-0141525810.1016/j.jgar.2024.12.016Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, BangladeshZannat Kawser0Sushmita Sridhar1Sanchita Kar2Tanbir Habib3Sharmin Akter Mukta4Kasrina Azad5Neyamul Hasan6Umme Kulsum7Abu Bakar Siddik8Saikt Rahman9Nusrat Noor Tanni10Maherun Nesa11Ashlee M. Earl12Colin J. Worby13Sarah E. Turbett14SM Shamsuzzaman15Jason B Harris16Firdausi Qadri17Regina C LaRocque18institute for developing Science and Health initiatives, Dhaka, Bangladesh; Zannat Kawser, Sushmita Sridhar and Sanchita Kar contributed equally to this work.Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA USA; Zannat Kawser, Sushmita Sridhar and Sanchita Kar contributed equally to this work.institute for developing Science and Health initiatives, Dhaka, Bangladesh; Zannat Kawser, Sushmita Sridhar and Sanchita Kar contributed equally to this work.institute for developing Science and Health initiatives, Dhaka, Bangladeshinstitute for developing Science and Health initiatives, Dhaka, Bangladeshinstitute for developing Science and Health initiatives, Dhaka, Bangladeshinstitute for developing Science and Health initiatives, Dhaka, Bangladeshinstitute for developing Science and Health initiatives, Dhaka, Bangladeshinstitute for developing Science and Health initiatives, Dhaka, Bangladeshinstitute for developing Science and Health initiatives, Dhaka, BangladeshDhaka Medical College and Hospital, Dhaka, BangladeshDhaka Medical College and Hospital, Dhaka, BangladeshInfectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA USAInfectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA USADivision of Infectious Diseases, Massachusetts General Hospital, Boston, MA USA; Harvard Medical School, Boston, MA USA; Department of Pathology, Massachusetts General Hospital, Boston, MA USADhaka Medical College and Hospital, Dhaka, BangladeshHarvard Medical School, Boston, MA USA; Massachusetts General Hospital for Children, Boston, MA USAinstitute for developing Science and Health initiatives, Dhaka, Bangladesh; International Centre for Diarrhoeal Disease Research, Dhaka, BangladeshDivision of Infectious Diseases, Massachusetts General Hospital, Boston, MA USA; Harvard Medical School, Boston, MA USA; Corresponding author. Mailing address: Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114, USA.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.http://www.sciencedirect.com/science/article/pii/S2213716524004831Klebsiella pneumoniaeAntimicrobial resistanceBacterial virulenceSequence types
spellingShingle 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
Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, Bangladesh
Journal of Global Antimicrobial Resistance
Klebsiella pneumoniae
Antimicrobial resistance
Bacterial virulence
Sequence types
title Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, Bangladesh
title_full Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, Bangladesh
title_fullStr Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, Bangladesh
title_full_unstemmed Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, Bangladesh
title_short Clinical and genomic characterization of Klebsiella pneumoniae infections in Dhaka, Bangladesh
title_sort clinical and genomic characterization of klebsiella pneumoniae infections in dhaka bangladesh
topic Klebsiella pneumoniae
Antimicrobial resistance
Bacterial virulence
Sequence types
url http://www.sciencedirect.com/science/article/pii/S2213716524004831
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