Epidemiology and molecular characteristics of the type VI secretion system in Klebsiella pneumoniae isolated from bloodstream infections
Abstract
BACKGROUND: The type VI secretion system (T6SS) has been identified as a novel virulence factor. This study aimed to investigate the prevalence of the T6SS genes in Klebsiella pneumoniae-induced bloodstream infections (BSIs). We also evaluated clinical and molecular characteristics of T6SS-positive K pneumoniae.
METHODS: A total of 344 non-repetitive K. pneumoniae bloodstream isolates and relevant clinical data were collected from January 2016 to January 2019. For all isolates, T6SS genes, capsular serotypes, and virulence genes were detected by polymerase chain reaction, and antimicrobial susceptibility was tested by VITEK® 2 Compact. MLST was being conducted for hypervirulent K. pneumoniae (HVKP).
RESULTS: 69 (20.1%) were identified as T6SS-positive K. pneumoniae among 344 isolates recovered from patients with BSIs. The rate of K1 capsular serotypes and ten virulence genes in T6SS-positive strains was higher than T6SS-negative strains (P = .000). The T6SS-positive rate was significantly higher than T6SS-negative rate among HVKP isolates. (P = .000). The T6SS-positive K. pneumoniae isolates were significantly more susceptible to cefoperazone-sulbactam, ampicillin-sulbactam, cefazolin, ceftriaxone, cefotan, aztreonam, ertapenem, amikacin, gentamicin, levofloxacin, and ciprofloxacin (P < 0.05). More strains isolated from the community and liver abscess were T6SS-positive K. pneumoniae (P < .05). Multivariate regression analysis indicated that community-acquired BSIs (OR…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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