High risk clones of Klebsiella pneumoniae resistant to broad spectrum Beta-lactams: A One Health perspective
Klebsiella pneumoniae is widespread organism in nature and regular colonizer of several mucous surfaces of humans and animals. Because of that, it is a Gram negative bacteria especially related to important infections, as well as usually found as food contaminant due to fail in the hygiene processes. As a further consequence of the use of broad spectrum cephalosporins (BSC), carbapenems, polymyxins and aminoglycosides, the isolation of bacterial lineages resistant to such antimicrobials has been exponentially increased. This is due to selection of strains and the horizontal transmission of mobile genetic elements carrying resistance genes through species in different environments. Since this spread is because specific lineages and plasmids, it is mandatory to know those elements related to antimicrobial resistance spreading through health-care institutions and food, which will allow the establishment of strategies in order to reduce this movement. For that, we propose to compare the BSC- and/or carbapenem-resistant K. pneumoniae isolated from patients admitted to the medicine general settings of a tertiary-care hospital in the State of Sao Paulo, from the hospital food and the retail meats and vegetables.. Up to 180 unique isolates from patients and about 200 isolates from more than 1000 food samples will be compared in order to identify differences in the antimicrobial susceptibility profiles, the genes codifying for resistance to broad-spectrum lactams, polymyxins or aminoglycosides, the plasmids which carry those genes, and the Sequence Type (ST) lineages. By the end of the study, we expect to verify if feeding is a possible route for transmission of resistance to antimicrobial classes of clinical significance to hospitalized patients indeed. Furthermore, look forward to establish the epidemiology of the resistant ST lineages in the hospital. Such results will also be base for a next intervention project that will aim the combat of antimicrobial resistance spread in bacteria of medical relevance in our institution.