ArticleThe Journal of infection2019
Multifaceted mechanisms of colistin resistance revealed by genomic analysis of multidrug-resistant Klebsiella pneumoniae isolates from individual patients before and after colistin treatment.
Article in The Journal of infection, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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24 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Global prevalence of mutation in theFrontiers in microbiology · 2024Pooled it
- Clinical and genomic characteristics of hypervirulent Klebsiella pneumoniae isolated from throat culture suggesting an emerging causative agent of pharyngitis.BMC infectious diseases · 2026Article
- Molecular analysis of polymyxin B resistance in clinical carbapenem-resistant Klebsiella pneumoniae isolates from a large tertiary care teaching hospital in Southwest China.BMC microbiology · 2026Article
- Proteome-wide remodelling in Klebsiella pneumoniae during step-wise adaptive evolution against colistin.PloS one · 2026Article
- A systematic analysis of various clonal lineages of colistin-resistant Klebsiella pneumoniae with mgrB mutations.Molecular biology reports · 2025Review
- Insertion sequences inFrontiers in microbiology · 2025Article
- Disruption of mgrB gene by ISkpn14 sourced from a blaBMC microbiology · 2024Article
- Situation Report on mcr-Carrying Colistin-Resistant Clones of Enterobacterales: A Global Update Through Human-Animal-Environment Interfaces.Current microbiology · 2023Review
- Article
- Lipid A Modification and Metabolic Adaptation in Polymyxin-Resistant, New Delhi Metallo-β-Lactamase-Producing Klebsiella pneumoniae.Microbiology spectrum · 2023Article
- Critical role of the RpoE stress response pathway in polymyxin resistance of Escherichia coli.The Journal of antimicrobial chemotherapy · 2023Article
- Prevalence of the colistin resistance geneAIMS microbiology · 2023Article
- Prevalence of Mutated Colistin-ResistantTropical medicine and infectious disease · 2022Review
- Prevalence and Molecular Characteristics of Polymyxin-ResistantAntibiotics (Basel, Switzerland) · 2022Article
- Prevalence of insertion sequence elements in plasmids relating to mgrB gene disruption causing colistin resistance in Klebsiella pneumoniae.MicrobiologyOpen · 2022Article
- Rapid high-resolution detection of colistin resistance in Gram-negative bacteria using flow cytometry: a comparison with broth microdilution, a commercial screening test and WGS.The Journal of antimicrobial chemotherapy · 2021Article
- Comparative genome analysis of colistin-resistant OXA-48-producing Klebsiella pneumoniae clinical strains isolated from two Iranian hospitals.Annals of clinical microbiology and antimicrobials · 2021Article
- Risk Factors for and Mechanisms ofOpen forum infectious diseases · 2021Article
- A Bibliometric Meta-Analysis of Colistin Resistance inDiseases (Basel, Switzerland) · 2021Article
- Colistin Resistance Among Multiple Sequence Types ofFrontiers in microbiology · 2021Article
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10 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesPolymyxins (i.e., polymyxin B and colistin) are used as a last-line therapy to combat multidrug-resistant (MDR) Klebsiella pneumoniae. Worryingly, polymyxin resistance in K. pneumoniae is increasingly reported worldwide. This study identified the genetic variations responsible for high-level colistin resistance in MDR K. pneumoniae clinical isolates.
methodsSixteen MDR K. pneumoniae isolates were obtained from stool samples of 8 patients before and after colistin treatment. Their genomes were sequenced on Illumina MiSeq to determine genetic variations.
resultsFifteen of 16 isolates harboured ISKpn26-like element insertion at nucleotide position 75 of mgrB, abolishing its negative regulation on phoPQ; while colistin-susceptible ATH7 contained intact mgrB and phoQ. Interestingly, each of the 7 mgrB-disrupted, colistin-susceptible isolates contained a nonsynonymous substitution in PhoQ (G39S, L239P, N253T or V446G), potentially impairing its function and intergenically suppressing the effect caused by mgrB inactivation. Additionally, three of the 7 corresponding mgrB-disrupted, colistin-resistant isolates harboured a secondary nonsynonymous substitution in PhoQ (N253P, D438H or T439P).
conclusionsThis is the first report of phoQ mutations in mgrB-disrupted, colistin-susceptible K. pneumoniae clinical isolates. We also discovered multiple phoQ mutations in mgrB-disrupted, colistin-resistant strains. Our findings highlight the multifaceted molecular mechanisms of colistin resistance in K. pneumoniae.
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