title: Phenotypic and Molecular Characterization of Antimicrobial Resistance in Klebsiella spp. Isolates from Companion Animals in Japan: Clonal Dissemination of Multidrug-Resistant Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae.
abstract: The emergence of antimicrobial resistance in Klebsiella spp., including resistance to extended-spectrum cephalosporins (ESC) and fluoroquinolones, is of great concern in both human and veterinary medicine. In this study, we investigated the prevalence of antimicrobial resistance in a total of 103 Klebsiella spp. isolates, consisting of Klebsiella pneumoniae complex (KP, n = 89) and K. oxytoca (KO, n = 14) from clinical specimens of dogs and cats in Japan. Furthermore, we characterized the resistance mechanisms, including extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC β-lactamase (PABL), and plasmid-mediated quinolone resistance (PMQR); and assessed genetic relatedness of ESC-resistant Klebsiella spp. strains by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Antimicrobial susceptibility testing demonstrated that resistance rates to ampicillin, cephalothin, enrofloxacin, ciprofloxacin, trimethoprim/sulfamethoxazole, cefotaxime, gentamicin, tetracycline, chloramphenicol, amoxicillin-clavulanic acid, and cefmetazole were 98.1, 37.9, 37.9, 35.9, 35.0, 34.0, 31.1, 30.1, 28.2, 14.6, and 6.8%, respectively. Phenotypic testing detected ESBLs and/or AmpC β-lactamases in 31 of 89 (34.8%) KP isolates, but not in KO isolates. Resistances to 5 of the 12 antimicrobials tested, as well as the three PMQRs [qnrB, qnrS, and aac(6')-Ib-cr], were detected significantly more frequently in ESBL-producing KP, than in non-ESBL-producing KP and KO. The most frequent ESBL was CTX-M-15 (n = 13), followed by CTX-M-14 (n = 7), CTX-M-55 (n = 6), SHV-2 (n = 5), CTX-M-2 (n = 2), and CTX-M-3 (n = 2). Based on the rpoB phylogeny, all ESBL-producing strains were identified as K. pneumoniae, except for one CTX-M-14-producing strain, which was identified as K. quasipneumoniae. All of AmpC β-lactamase positive isolates (n = 6) harbored DHA-1, one of the PABLs. Based on MLST and PFGE analysis, ST15 KP clones producing CTX-M-2, CTX-M-15, CTX-M-55, and/or SHV-2, as well as KP clones of ST1844-CTX-M-55, ST655-CTX-M-14, and ST307-CTX-M-15, were detected in one or several hospitals. Surprisingly, specific clones were detected in different patients at an interval of many months. These results suggest that multidrug-resistant ESBL-producing KP were clonally disseminated among companion animals via not only direct but also indirect transmission. This is the first report on large-scale monitoring of antimicrobial-resistant Klebsiella spp. isolates from companion animals in Japan.
authors.affiliation: Department of Veterinary Internal Medicine, Tottori University Tottori, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Veterinary Internal Medicine, Tottori University Tottori, Japan.
authors.forename: Takae
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Laboratory of Veterinary Microbiology, Nippon Veterinary and Life Science University Tokyo, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Mukai
authors.affiliation: Laboratory of Veterinary Microbiology, Nippon Veterinary and Life Science University Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kuwajima
authors.affiliation: Laboratory of Food Microbiology and Food Safety, Rakuno Gakuen University Hokkaido, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Sato
authors.affiliation: Laboratory of Food Microbiology and Food Safety, Rakuno Gakuen University Hokkaido, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Usui
authors.affiliation: Laboratory of Food Microbiology and Food Safety, Rakuno Gakuen University Hokkaido, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tamura
authors.affiliation: Miyamoto Animal Hospital Yamaguchi, Japan.
authors.forename: Yui
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Miyamoto Animal Hospital Yamaguchi, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Sanritsu Zelkova Veterinary Laboratory Kanagawa, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Tsuyuki
authors.affiliation: Monoris Co., Ltd. Tokyo, Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Ohki
authors.affiliation: Laboratory of Veterinary Microbiology, Nippon Veterinary and Life Science University Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kataoka
keywords: Klebsiella spp.; cats; clonal dissemination; dogs; extended-spectrum β-lactamases; multidrug resistance