title: Pyrosequencing-based analysis reveals a novel capsular gene cluster in a KPC-producing Klebsiella pneumoniae clinical isolate identified in Brazil.
abstract: BACKGROUND
  An important virulence factor of Klebsiella pneumoniae is the production of capsular polysaccharide (CPS), a thick mucus layer that allows for evasion of the host's defense and creates a barrier against antibacterial peptides. CPS production is driven mostly by the expression of genes located in a locus called cps, and the resulting structure is used to distinguish between different serotypes (K types). In this study, we report the unique genetic organization of the cps cluster from K. pneumoniae Kp13, a clinical isolate recovered during a large outbreak of nosocomial infections that occurred in a Brazilian teaching hospital.
  
  
  RESULTS
  A pyrosequencing-based approach showed that the cps region of Kp13 (cpsKp13) is 26.4 kbp in length and contains genes common, although not universal, to other strains, such as the rmlBADC operon that codes for L-rhamnose synthesis. cpsKp13 also presents some unique features, like the inversion of the wzy gene and a unique repertoire of glycosyltransferases. In silico comparison of cpsKp13 RFLP pattern with 102 previously published cps PCR-RFLP patterns showed that cpsKp13 is distinct from the C patterns of all other K serotypes. Furthermore, in vitro serotyping showed only a weak reaction with capsular types K9 and K34. We confirm that K9 cps shares common genes with cpsKp13 such as the rmlBADC operon, but lacks features like uge and Kp13-specific glycosyltransferases, while K34 capsules contain three of the five sugars that potentially form the Kp13 CPS.
  
  
  CONCLUSIONS
  We report the first description of a cps cluster from a Brazilian clinical isolate of a KPC-producing K. pneumoniae. The gathered data including K-serotyping support that Kp13's K-antigen belongs to a novel capsular serotype. The CPS of Kp13 probably includes L-rhamnose and D-galacturonate in its structure, among other residues. Because genes involved in L-rhamnose biosynthesis are absent in humans, this pathway may represent potential targets for the development of antimicrobial agents. Studying the capsular serotypes of clinical isolates is of great importance for further development of vaccines and/or novel therapeutic agents. The distribution of K-types among multidrug-resistant isolates is unknown, but our findings may encourage scientists to perform K-antigen typing of KPC-producing strains worldwide.
authors.affiliation: Laboratório Nacional de Computação Científica (LNCC), Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Pablo Ivan Pereira
authors.initials: PI
authors.lastname: Ramos
authors.forename: Renata Cristina
authors.initials: RC
authors.lastname: Picão
authors.forename: Eliana Carolina
authors.initials: EC
authors.lastname: Vespero
authors.forename: Marsileni
authors.initials: M
authors.lastname: Pelisson
authors.forename: Luiz Fernando Goda
authors.initials: LF
authors.lastname: Zuleta
authors.forename: Luiz Gonzaga P
authors.initials: LG
authors.lastname: Almeida
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Gerber
authors.forename: Ana Tereza R
authors.initials: AT
authors.lastname: Vasconcelos
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Gales
authors.forename: Marisa Fabiana
authors.initials: MF
authors.lastname: Nicolás
mesh_terms: D016667:Bacterial Capsules / Q000235:genetics*; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology* / Q000235:genetics* / Q000302:isolation & purification; D008969:Molecular Sequence Data; D058889:Molecular Typing; D005810:Multigene Family; D017422:Sequence Analysis, DNA; D012703:Serotyping; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D004269:DNA, Bacterial; D001618:beta-Lactamases