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- Title
Colistin Heteroresistance in Klebsiella Pneumoniae Isolates and Diverse Mutations of PmrAB and PhoPQ in Resistant Subpopulations.
- Authors
Cheong, Hae Suk; Kim, So Yeon; Wi, Yu Mi; Peck, Kyong Ran; Ko, Kwan Soo
- Abstract
Heteroresistance may pose a threat to the prognosis of patients following colistin treatment. We investigated colistin heteroresistance in Klebsiella pneumoniae isolates from South Korea. Among 252 K. pneumoniae blood isolates, 231 were susceptible to polymyxins. Heteroresistance to colistin was determined using population analysis profiles, disk diffusion assays, and E-test strip tests for the susceptible isolates. As a result, we identified three colistin-heteroresistant K. pneumoniae isolates belonging to separate clones (ST11, ST461, and ST3217) by multilocus sequence typing analysis. Two colistin-resistant subpopulations were selected from each heteroresistant isolate in either disk diffusion testing or E-testing. Two resistant subpopulations from the same isolate exhibited different amino acid substitutions in the two-component regulatory systems PmrAB and PhoPQ. An in vitro time–kill assay showed that meropenem combined with colistin had a 1× minimum inhibitory concentration bactericidal effect against a multidrug-resistant, colistin-heteroresistant isolate.
- Subjects
SOUTH Korea; KLEBSIELLA pneumoniae; COLISTIN; DISC diffusion tests (Microbiology); BACTERICIDAL action; SEQUENCE analysis; MEROPENEM; KLEBSIELLA infections; AMINO acids
- Publication
Journal of Clinical Medicine, 2019, Vol 8, Issue 9, p1444
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm8091444