Porin-Mediated Carbapenem Resistance in Klebsiella pneumoniae: an Alarming Threat to Global Health

Vaara M. Polymyxins and their potential next generation as therapeutic antibiotics. Front Microbiol. 2019;10:1–6. https://doi.org/10.3389/fmicb.2019.01689.

Article  Google Scholar 

Frieri M, Kumar K, Boutin A. Antibiotic resistance. J Infect. Public Health. 2017;10:369–78. https://doi.org/10.1016/j.jiph.2016.08.007.

Article  Google Scholar 

Singh N, Sit MT, Chung DM, Lopez AA, Weerackoon R, Yeh PJ. How often are antibiotic-resistant bacteria said to “evolve” in the news? PLoS One. 2016;11:1–12. https://doi.org/10.1371/journal.pone.0150396.

Article  CAS  Google Scholar 

Sharma VK, Johnson N, Cizmas L, McDonald TJ, Kim H. A review of the influence of treatment strategies on antibiotic resistant bacteria and antibiotic resistance genes. Chemosphere. 2016;150:702–14. https://doi.org/10.1016/j.chemosphere.2015.12.084.

Article  CAS  PubMed  Google Scholar 

Wei J, Wenjie Y, Ping L, Na W, Haixia R, Xuequn Z. Antibiotic resistance of Klebsiella pneumoniae through β-arrestin recruitment-induced β-lactamase signaling pathway. Exp Ther Med. 2018;15:2247–54. https://doi.org/10.3892/etm.2018.5728.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Bradley JS, Garau J, Lode H, Rolston KVI, Wilson SE, Quinn JP. Carbapenems in clinical practice: a guide to their use in serious infection. Int J Antimicrob Agents. 1999;11:93–100. https://doi.org/10.1016/S0924-8579(98)00094-6.

Article  CAS  PubMed  Google Scholar 

Torres JA, Villegas MV, Quinn JP. Current concepts in antibiotic-resistant gram-negative bacteria. Expert Rev Anti Infect Ther. 2007;5(5):833–43. https://doi.org/10.1586/14787210.5.5.833.

Article  CAS  PubMed  Google Scholar 

Papp-Wallace KM, Endimiani A, Taracila MA, Bonomo RA. Carbapenems: past, present, and future. Antimicrob Agents Chemother. 2011;55:4943–60. https://doi.org/10.1128/AAC.00296-11.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Holt KE, Wertheim H, Zadoks RN, Baker S, Whitehouse CA, Dance D, et al. Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae, an urgent threat to public health. Proc Natl Acad Sci U S A. 2015;112:E3574–81. https://doi.org/10.1073/pnas.1501049112.

Article  CAS  PubMed  PubMed Central  Google Scholar 

•• Indrajith S, Mukhopadhyay AK, Chowdhury G, Farraj DAA, Alkufeidy RM, Natesan S, et al. Molecular insights of Carbapenem resistance Klebsiella pneumoniae isolates with focus on multidrug resistance from clinical samples. J Infect Public Health. 2021;14:131–8. https://doi.org/10.1016/j.jiph.2020.09.018. (This article evaluated the distribution pattern of carbapenem resistance genes along with the major porins among K. pneumoniae- OmpK35 and OmpK36 where the loss of porins correlates with other mechanisms to contribute high carbapenem resistance in the bacteria.)

Article  PubMed  Google Scholar 

Pitout JDD, Gregson DB, Church DL, Laupland KB. Population-based laboratory surveillance for AmpC β-lactamase- producing Escherichia coli, Calgary. Emerg Infect Dis. 2007;13:443–8. https://doi.org/10.3201/eid1303.060447.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jacoby GA. AmpC Β-lactamases. Clin Microbiol Rev. 2009;22:161–82. https://doi.org/10.1128/CMR.00036-08.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Navon-Venezia S, Kondratyeva K, Carattoli A. Klebsiella pneumoniae: a major worldwide source and shuttle for antibiotic resistance. FEMS Microbiol Rev. 2017;41(3):252–75. https://doi.org/10.1093/femsre/fux013.

Article  CAS  PubMed  Google Scholar 

Soto SM. Role of efflux pumps in the antibiotic resistance of bacteria embedded in a biofilm. Virulence. 2013;4(3):223–9. https://doi.org/10.4161/viru.23724.

Article  PubMed  PubMed Central  Google Scholar 

Dever LA, Dermody TS. Mechanisms of bacterial resistance to antibiotics. Arch Intern Med. 1991;151(5):886–95. https://doi.org/10.1001/archinte.1991.00400050040010.

Article  CAS  PubMed  Google Scholar 

Abbas AF, Al-Saadi AG, Hussein AK, Al-Thaheb AO. Role of outer membrane proteins in virulence of Klebsiella ozaenae and antibiotic sensitivity. J Phys Conf Ser. 2019;1294(6):062088. https://doi.org/10.1088/1742-6596/1294/6/062088.

Gold HS, Moellering RC Jr. Antimicrobial-drug resistance. N Engl J Med. 1996;335(19):1445–53.

Article  CAS  PubMed  Google Scholar 

Aghapour Z, Gholizadeh P, Ganbarov K, Bialvaei AZ, Mahmood SS, Tanomand A, Yousefi M, Asgharzadeh M, Yousefi B, Kafil HS. Molecular mechanisms related to colistin resistance in Enterobacteriaceae. Infect Drug Resist. 2019;12:965–975. https://doi.org/10.2147/IDR.S199844.

Aguilera-Alonso D, Escosa-García L, Saavedra-Lozano J, Cercenado E, Baquero-Artigao F. Carbapenem-resistant gram-negative bacterial infections in children. Antimicrob Agents Chemother. 2020;64(3):e02183-e2219.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kong HK, Pan Q, Lo WU, Liu X, Law COK, Chan TF, et al. Fine-tuning carbapenem resistance by reducing porin permeability of bacteria activated in the selection process of conjugation. Sci Rep. 2018;8:1–11. https://doi.org/10.1038/s41598-018-33568-8.

Article  CAS  Google Scholar 

Martin RM, Bachman MA. Colonization, infection, and the accessory genome of Klebsiella pneumoniae. Front Cell Infect Microbiol. 2018;8:1–15. https://doi.org/10.3389/fcimb.2018.00004.

Article  CAS  Google Scholar 

Ashurst JV, Dawson A. Klebsiella Pneumonia. 2023. In StatPearls. StatPearls Publishing.

Podschun R, Ullmann U. Bacteriocin typing of Klebsiella spp. isolated from different sources. Zentralbl Hyg Umweltmed=Int J Hyg Environ Med. 1996;198(3):258–64.

CAS  Google Scholar 

Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care–associated infections. N Engl J Med. 2014;370:1198–208. https://doi.org/10.1056/nejmoa1306801.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Schroll C, Barken KB, Krogfelt KA, Struve C. Role of type 1 and type 3 fimbriae in Klebsiella pneumoniae biofilm formation. BMC Microbiol. 2010;10:1–10. https://doi.org/10.1186/1471-2180-10-179.

Davies J. Origins and evolution of antibiotic resistance. Microbiologia. 1996;12:9–16. https://doi.org/10.1128/mmbr.00016-10.

Article  CAS  PubMed  Google Scholar 

Ferreira RL, Da Silva BCM, Rezende GS, Nakamura-Silva R, Pitondo-Silva A, Campanini EB, et al. High prevalence of multidrug-resistant Klebsiella pneumoniae harboring several virulence and β-lactamase encoding genes in a Brazilian intensive care unit. Front Microbiol. 2019;9:3198. https://doi.org/10.3389/fmicb.%202018.03198.

Lee YQ, Sri S, Sri L, Chong CW, Karunakaran R, Vellasamy KM, et al. Characterisation of non-carbapenemase-producing carbapenem-resistant Klebsiella pneumoniae based on their clinical and molecular profile in Malaysia. Antibiotics (Basel). 2022;10(11):1670.

Article  Google Scholar 

Organización Mundial de la Salud. Report on the burden of endemic health care-associated infection worldwide clean care is safer care. World Heal Organ. 2011;3:1–21.

Google Scholar 

• Cao Z, Yue C, Kong Q, Liu Y, Li J. Risk factors for a hospital-acquired carbapenem-resistant Klebsiella pneumoniae bloodstream infection: A Five-Year Retrospective Study. Infect Drug Resist. 2022;15:641–54. https://doi.org/10.2147/IDR.S342103. (This article analyzed the risk factors of hospital-acquired K. pneumoniae bloodstream infection and the prevalence of drug resistance over the recent five years. Their multivariant analysis also revealed how β-lactam/β-lactamase inhibitor combinations (BLBLIs) are becoming an independent risk factor for hospital-acquired infections.)

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hu FP, Guo Y, Zhu DM, Wang F, Jiang XF, Xu YC, Zhang XJ, Zhang CX, Ji P, Xie Y, Kang M. Resistance trends among clinical isolates in China reported from CHINET surveillance of bacterial resistance, 2005–2014. Clin Microbiol Infect. 2016;1(22):S9-14.

Article  Google Scholar 

Li Y, Shen H, Zhu C, Yu Y. Carbapenem-resistant Klebsiella pneumoniae infections among ICU admission patients in Central China : prevalence and prediction model. Biomed Res Int. 2019;2019. https://doi.org/10.1155/2019/9767313.

Lin YT, Siu LK, Lin JC, Chen TL, Tseng CP, Yeh KM, Chang FY, Fung CP. Seroepidemiology of Klebsiella pneumoniae colonizing the intestinal tract of healthy Chinese and overseas Chinese adults in Asian countries. BMC Microbiol. 2012;12(1):1–7.

Article  Google Scholar 

Russo TA, Olson R, Fang CT, Stoesser N, Miller M, MacDonald U, Hutson A, Barker JH, La Hoz RM, Johnson JR. Identification of biomarkers for differentiation of hypervirulent Klebsiella pneumoniae from classical K. pneumoniae. J Clin Microbiol. 2018;56(9):e00776-18.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Chang D, Sharma L, Dela Cruz CS, Zhang D. Clinical epidemiology, risk factors, and control strategies of Klebsiella pneumoniae infection. Front Microbiol. 2021;12:1–9. https://doi.org/10.3389/fmicb.2021.750662.

Article  Google Scholar 

Zhang S, Yang G, Ye Q, Wu Q, Zhang J, Huang Y. Phenotypic and genotypic characterization of Klebsiella pneumoniae isolated from retail foods in China. Front Microbiol. 2018;9:1–11. https://doi.org/10.3389/fmicb.2018.00289.

Article  Google Scholar 

Shao C, Wang W, Liu S, Zhang Z, Jiang M, Zhang F. Molecular epidemiology and drug resistant mechanism of carbapenem-resistant Klebsiella pneumoniae in elderly patients with lower respiratory tract infection. Front Public Heal. 2021;9:1–10. https://doi.org/10.3389/fpubh.2021.669173.

Article  Google Scholar 

Patel G, Huprikar S, Factor SH, Jenkins SG, Calfee DP. Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infect Control Hosp Epidemiol. 2008;29(12):1099–106.

Article  PubMed  Google Scholar 

Lan P, Jiang Y, Zhou J, Yu Y. A global perspective on the convergence of hypervirulence and carbapenem resistance in Klebsiella pneumoniae. J Glob Antimicrob Resist. 2021;25:26–34. https://doi.org/10.1016/j.jgar.2021.02.020.

Article  CAS  PubMed  Google Scholar 

Borer A, Saidel-Odes L, Eskira S, Nativ R, Riesenberg K, Livshiz-Riven I, et al. Risk factors for developing clinical infection with carbapenem-resistant Klebsiella pneumoniae in hospital patients initially only colonized with carbapenem-resistant K pneumoniae. Am J Infect Control. 2012;40:421–5. https://doi.org/10.1016/j.ajic.2011.05.022.

Article  PubMed 

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