Case of meningitis in a neonate caused by an extended-spectrum-beta-lactamase-producing strain of hypervirulent Klebsiella pneumoniae

© 2017 Khaertynov, Anokhin, Davidyuk, Nicolaeva, Khalioullina, Semyenova, Alatyrev, Skvortsova and Abrahamyan. Klebsiella pneumoniae is one of the most important infectious agents among neonates. This pathogen has a potential to develop an increased antimicrobial resistance and virulence. The classic non-virulent strain of K. pneumoniae, producing an extended-spectrum beta-lactamases (ESBL), is associated with nosocomial infection mainly in preterm neonates. Hypervirulent K. pneumoniae strains are associated with invasive infection among previously healthy ambulatory patients, and most of them exhibit antimicrobial susceptibility. During the last few years, several cases of diseases caused by hypervirulent K. pneumoniae producing ESBL have been registered in different geographical regions of the world. However , reports of such cases in neonates are rare. Here, we reported that this pathogen can cause pyogenic meningitis in full-term neonate with poor prognosis. A previously healthy, full-term, 12-day-old neonate was admitted to the infectious diseases hospital with suspected meningitis. The clinical symptoms included loss of appetite, irritability, fever, seizures, and a bulging anterior fontanelle. The analysis of the cerebrospinal fluid confirmed the diagnosis of meningitis. Blood and cerebrospinal fluid cultures were positive for K. pneumoniae, producing ESBL. K. pneumoniae isolates were resistant to aminopenicillins, 3rd generation cephalosporins but were sensitive to imipenem and meropenem. The "string test" was positive. The study of the virulence factors of K. pneumoniae by PCR revealed the presence of the rmpA gene. A combination of K. pneumoniae virulence and drug resistance complicated by cerebral oedema led to the death of the neonate. We concluded that both the risk of developing severe forms of infection and the outcome of the disease due to K. pneumonia are associated with the phenotypic features of the pathogen such as its antibiotic susceptibility and virulence factors. Emergence of the ESBL-producing strain of hypervirulent K. pneumoniae could represent a new serious threat to public health, suggesting an urgent need to enhance clinical awareness and epidemiological surveillance

Phenotypes of pseudomonas aeruginosa strains, isolated in surgical clinics

After studying of 83 strains of P. aeruginosa we revealed the phenotypic heterogeneity (in phospholipase activity, biofilm-forming capacity, resistance to antibiotics et al.) of bacterial populations both in different departments within one multi-specialized clinic and in different surgical clinics. We determined, that strains, isolated from intensive care unit, have the largest number of expressive pathogenic factors and high multiple drug resistance. The likeness or difference of phenotypic characteristics of P. aeruginosa, which is inductive, don't let us estimate definitely the possibility of strain migration from the intensive care unit into another departments of the multi-specialized clinic, as we don't know clearly if the heterogeneity of population of P. aeruginosa is conditioned by modified variability or its differences are fixed in the genome. Permanently preserved conditions and typical contingent of patients in specialized departments contribute to the forming of profiled phenotypes among the isolated strains.В результате изучения 83 штаммов P. aeruginosa, выявлена фенотипическая гетерогенность (по фосфолипазной, пленкообразующей способности, антибиотикорезистентности и др.) популяций синегнойной палочки в различных отделениях одного многопрофильного, а также в разных хирургических стационарах г. Перми. Установлено, что штаммы, изолированные из ОРИТ, характеризуются наиболее широким набором экспрессируемых факторов патогенности и выраженной множественной лекарственной устойчивостью. Сходство или различие фенотипических характеристик изолятов P. aeruginosa, проявление которых в значительной степени индуцибельно, не позволяют однозначно оценить вероятность миграции штаммов, изолированных в ОРИТ, в другие отделения многопрофильного хирургического стационара, поскольку не ясно, обусловлена ли гетерогенность популяций синегнойной палочки модификационной изменчивостью или их отличия закреплены в геноме. Перманентно сохраняющиеся условия и типичные контингенты специализированных отделений способствуют формированию среди изолируемых в них культур профилированных фенотипов

Comparative analysis of pseudomonas aeruginosa phenotypes, isolated in multi-specialized surgical clinics

After the phenotypic studying of Pseudomonas aeruginosa strains, circulating in different departments of multi-specialized surgical clinic, we revealed, that the part of multi-resistant cultures accounts for 86,2%, but the isolates from different departments differed importantly in their spectrum of sensitivity towards basic antipseudomonade drugs. All strains produced the pigment and showed the hemolytic activity. The expression of phospholipase activity and the capacity for generation of biofilms were significantly variable

Case of meningitis in a neonate caused by an extended-spectrum-beta-lactamase-producing strain of hypervirulent Klebsiella pneumoniae

© 2017 Khaertynov, Anokhin, Davidyuk, Nicolaeva, Khalioullina, Semyenova, Alatyrev, Skvortsova and Abrahamyan. Klebsiella pneumoniae is one of the most important infectious agents among neonates. This pathogen has a potential to develop an increased antimicrobial resistance and virulence. The classic non-virulent strain of K. pneumoniae, producing an extended-spectrum beta-lactamases (ESBL), is associated with nosocomial infection mainly in preterm neonates. Hypervirulent K. pneumoniae strains are associated with invasive infection among previously healthy ambulatory patients, and most of them exhibit antimicrobial susceptibility. During the last few years, several cases of diseases caused by hypervirulent K. pneumoniae producing ESBL have been registered in different geographical regions of the world. However , reports of such cases in neonates are rare. Here, we reported that this pathogen can cause pyogenic meningitis in full-term neonate with poor prognosis. A previously healthy, full-term, 12-day-old neonate was admitted to the infectious diseases hospital with suspected meningitis. The clinical symptoms included loss of appetite, irritability, fever, seizures, and a bulging anterior fontanelle. The analysis of the cerebrospinal fluid confirmed the diagnosis of meningitis. Blood and cerebrospinal fluid cultures were positive for K. pneumoniae, producing ESBL. K. pneumoniae isolates were resistant to aminopenicillins, 3rd generation cephalosporins but were sensitive to imipenem and meropenem. The "string test" was positive. The study of the virulence factors of K. pneumoniae by PCR revealed the presence of the rmpA gene. A combination of K. pneumoniae virulence and drug resistance complicated by cerebral oedema led to the death of the neonate. We concluded that both the risk of developing severe forms of infection and the outcome of the disease due to K. pneumonia are associated with the phenotypic features of the pathogen such as its antibiotic susceptibility and virulence factors. Emergence of the ESBL-producing strain of hypervirulent K. pneumoniae could represent a new serious threat to public health, suggesting an urgent need to enhance clinical awareness and epidemiological surveillance

Case of Meningitis in a Neonate Caused by an Extended-Spectrum-Beta-Lactamase-Producing Strain of Hypervirulent Klebsiella pneumoniae

Klebsiella pneumoniae is one of the most important infectious agents among neonates. This pathogen has a potential to develop an increased antimicrobial resistance and virulence. The classic non-virulent strain of K. pneumoniae, producing an extended-spectrum beta-lactamases (ESBL), is associated with nosocomial infection mainly in preterm neonates. Hypervirulent K. pneumoniae strains are associated with invasive infection among previously healthy ambulatory patients, and most of them exhibit antimicrobial susceptibility. During the last few years, several cases of diseases caused by hypervirulent K. pneumoniae producing ESBL have been registered in different geographical regions of the world. However, reports of such cases in neonates are rare. Here, we reported that this pathogen can cause pyogenic meningitis in full-term neonate with poor prognosis. A previously healthy, full-term, 12-day-old neonate was admitted to the infectious diseases hospital with suspected meningitis. The clinical symptoms included loss of appetite, irritability, fever, seizures, and a bulging anterior fontanelle. The analysis of the cerebrospinal fluid confirmed the diagnosis of meningitis. Blood and cerebrospinal fluid cultures were positive for K. pneumoniae, producing ESBL. K. pneumoniae isolates were resistant to aminopenicillins, 3rd generation cephalosporins but were sensitive to imipenem and meropenem. The “string test” was positive. The study of the virulence factors of K. pneumoniae by PCR revealed the presence of the rmpA gene. A combination of K. pneumoniae virulence and drug resistance complicated by cerebral oedema led to the death of the neonate. We concluded that both the risk of developing severe forms of infection and the outcome of the disease due to K. pneumonia are associated with the phenotypic features of the pathogen such as its antibiotic susceptibility and virulence factors. Emergence of the ESBL-producing strain of hypervirulent K. pneumoniae could represent a new serious threat to public health, suggesting an urgent need to enhance clinical awareness and epidemiological surveillance