title: Prevalence and characteristics of pks genotoxin gene cluster-positive clinical Klebsiella pneumoniae isolates in Taiwan.
abstract: The pks gene cluster encodes enzymes responsible for the synthesis of colibactin, a genotoxin that has been shown to induce DNA damage and contribute to increased virulence. The present study investigated the prevalence of pks in clinical K. pneumoniae isolates from a national surveillance program in Taiwan, and identified microbiological and molecular factors associated with pks-carriage. The pks gene cluster was detected in 67 (16.7%) of 400 isolates from various specimen types. Multivariate analysis revealed that isolates of K1, K2, K20, and K62 capsular types (p < 0.001), and those more susceptible to antimicrobial agents (p = 0.001) were independent factors strongly associated with pks-carriage. Phylogenetic studies on the sequence type (ST) and pulsed-field gel electrophoresis patterns indicated that the pks-positive isolates belong to a clonal group of ST23 in K1, a locally expanding ST65 clone in K2, a ST268-related K20 group, and a highly clonal ST36:K62 group. Carriage of rmpA, iutC, and ybtA, the genes associated with hypervirulence, was significantly higher in the pks-positive isolates than the pks-negative isolates (95.5% vs. 13.2%, p < 0.001). Further studies to determine the presence of hypervirulent pks-bearing bacterial populations in the flora of community residents and their association with different disease entities may be warranted.
authors.affiliation: Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.|Institute of Molecular and Genomic Medicine, National Health Research Institutes, Zhunan, Taiwan.|Biotechnology Center, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Ying-Tsong
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Department of Microbiology and Immunology, Chung-Shan Medical University, Taichung, Taiwan.|Division of Infectious Diseases, Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung, Taiwan.|Institute of Microbiology and Immunology, Chung-Shan Medical University, Taichung, Taiwan.
authors.forename: Yi-Chyi
authors.initials: YC
authors.lastname: Lai
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, 350 Taiwan.
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Tan
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, 350 Taiwan.
authors.forename: Li-Yun
authors.initials: LY
authors.lastname: Hsieh
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, 350 Taiwan.|Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jann-Tay
authors.initials: JT
authors.lastname: Wang
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, 350 Taiwan.
authors.forename: Yih-Ru
authors.initials: YR
authors.lastname: Shiau
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, 350 Taiwan.
authors.forename: Hui-Ying
authors.initials: HY
authors.lastname: Wang
authors.affiliation: Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Ann-Chi
authors.initials: AC
authors.lastname: Lin
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, 350 Taiwan.
authors.forename: Jui-Fen
authors.initials: JF
authors.lastname: Lai
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, 350 Taiwan.
authors.forename: I-Wen
authors.initials: IW
authors.lastname: Huang
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, 350 Taiwan.
authors.forename: Tsai-Ling
authors.initials: TL
authors.lastname: Lauderdale
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology*; D007711:Klebsiella pneumoniae / Q000201:enzymology / Q000235:genetics / Q000472:pathogenicity*; D008875:Middle Aged; D005810:Multigene Family; D010455:Peptides / Q000378:metabolism; D010802:Phylogeny; D061065:Polyketides / Q000378:metabolism; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology; D014774:Virulence / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics* / Q000378:metabolism; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D010455:Peptides; D061065:Polyketides; D037521:Virulence Factors; C569566:colibactin