ArticleScientific reports2019
Resistance mechanisms and population structure of highly drug resistant Klebsiella in Pakistan during the introduction of the carbapenemase NDM-1.
Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence and clonal diversity of carbapenem-resistant Klebsiella pneumoniae causing neonatal infections: A systematic review of 128 articles across 30 countries.PLoS medicine · 2023Pooled it
- Whole-genome characterization of a colistin-resistant Klebsiella quasipneumoniae subsp. quasipneumoniae isolate from a urinary tract infection in Peshawar, Pakistan.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2026Article
- Genomic characterization of plasmids harboringMicrobiology spectrum · 2025Article
- Prevalence of New Delhi Metallo-β-lactamase (blaMolecular biology reports · 2025Article
- High ceftazidime-avibactam resistance rate in carbapenem-resistant gram-negative organisms in Pakistan's pediatric population.Pakistan journal of medical sciences · 2025Article
- Genetic diversity, drug resistance, and biofilm formation in Klebsiella pneumoniae associated with nosocomial infection in Pelotas, RS, Brazil.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2025Article
- Epidemiology, antimicrobial resistance profile, associated risk factors and management of carbapenem resistant Klebsiella pneumoniae in children under 5 with suspected sepsis in Ethiopia.BMC infectious diseases · 2024Article
- Deciphering the gastrointestinal carriage ofInfection and immunity · 2024Review
- Semi-mechanistic modeling of resistance development to β-lactam and β-lactamase-inhibitor combinations.Journal of pharmacokinetics and pharmacodynamics · 2024Article
- Article
- A systematic review and meta-analysis of carbapenem resistance and its possible treatment options with focus on clinicalHeliyon · 2024Article
- Characterization and complete genome analysis of Klebsiella phage Kp109 with lytic activity against Klebsiella pneumoniae.Virus genes · 2024Article
- Exploration of Antimicrobial Peptides in the Treatment of Gentamicin-ResistantInfection and drug resistance · 2024Article
- Genomic Epidemiology of Carbapenem-ResistantAntimicrobial agents and chemotherapy · 2023Article
- Synergistic Activity of Tetrandrine and Colistin againstAntibiotics (Basel, Switzerland) · 2022Article
- Characterizing Antimicrobial Resistance in Clinically Relevant Bacteria Isolated at the Human/Animal/Environment Interface Using Whole-Genome Sequencing in Austria.International journal of molecular sciences · 2022Article
- LPS O Antigen Plays a Key Role in Klebsiella pneumoniae Capsule Retention.Microbiology spectrum · 2022Article
- Metagenomic Approaches Reveal Strain Profiling and Genotyping of Klebsiella pneumoniae from Hospitalized Patients in China.Microbiology spectrum · 2022Article
- PowerBacGWAS: a computational pipeline to perform power calculations for bacterial genome-wide association studies.Communications biology · 2022Article
- Genomic and antigenic diversity of colonizingMicrobial genomics · 2022Article
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11 authors.
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Abstract
Klebsiella pneumoniae is a major threat to public health with the emergence of isolates resistant to most, if not all, useful antibiotics. We present an in-depth analysis of 178 extended-spectrum beta-lactamase (ESBL)-producing K. pneumoniae collected from patients resident in a region of Pakistan, during the period 2010-2012, when the now globally-distributed carbapenemase bla-NDM-1 was being acquired by Klebsiella. We observed two dominant lineages, but neither the overall resistance profile nor virulence-associated factors, explain their evolutionary success. Phenotypic analysis of resistance shows few differences between the acquisition of resistance genes and the phenotypic resistance profile, including beta-lactam antibiotics that were used to treat ESBL-positive strains. Resistance against these drugs could be explained by inhibitor-resistant beta-lactamase enzymes, carbapenemases or ampC type beta-lactamases, at least one of which was detected in most, but not all relevant strains analysed. Complete genomes for six selected strains are reported, these provide detailed insights into the mobile elements present in these isolates during the initial spread of NDM-1. The unexplained success of some lineages within this pool of highly resistant strains, and the discontinuity between phenotypic resistance and genotype at the macro level, indicate that intrinsic mechanisms contribute to competitive advantage and/or resistance.
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