Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 26;14(2):128.
doi: 10.3390/antibiotics14020128.

Circulation of a Unique Klebsiella pneumoniae Clone, ST147 NDM-1/OXA-48, in Two Diverse Hospitals in Calabria (Italy)

Emanuele Nicitra  1 , Morena Terrana  1 , Dafne Bongiorno  1 , Saveria Dodaro  2 , Francesca Greco  2 , Sonia Greco  3 , Nadia Marascio  4 , Maria Vittoria Mauro  2 , Marta Pantanella  4 , Grete Francesca Privitera  5 , Angela Quirino  4 , Francesca Serapide  6 , Enrico Maria Trecarichi  6   7 , Valeria Vangeli  3 , Antonio Mastroianni  3 , Giovanni Matera  4 , Alessandro Russo  6 , Stefania Stefani  1
Affiliations

Circulation of a Unique Klebsiella pneumoniae Clone, ST147 NDM-1/OXA-48, in Two Diverse Hospitals in Calabria (Italy)

Emanuele Nicitra et al. Antibiotics (Basel). .

Abstract

Background/Objectives: Carbapenem-resistant Klebsiella pneumoniae has become endemic in Europe, including in Italy, where its prevalence has risen dramatically, primarily due to epidemic clones harboring metallo-enzymes. This study aims to investigate the dissemination of K. pneumoniae strains co-producing OXA-48 and NDM-1 between two hospitals in southern Italy using molecular analyses. Methods: A total of 49 K. pneumoniae strains, predominantly co-producing OXA-48 and NDM-1, were collected between March and December 2023. Antibiotic susceptibility testing was conducted following EUCAST guidelines. Whole-genome sequencing (Illumina MiSeq) and bioinformatics tools (CARD, CLC Genomics Workbench) were used to identify resistance and virulence genes, capsule loci, and phylogenetic relationships. Results: All isolates exhibited multidrug-resistant or extensively drug-resistant profiles, including resistance to ceftazidime/avibactam and meropenem/vaborbactam. Genomic analysis revealed diverse resistance genes such as blaOXA-48, blaNDM-1, blaCTX-M-15, and blaSHV variants. Virulence genes associated with capsules, fimbriae, and siderophores were widespread. Most strains were classified as ST147 by MLST and contained various plasmids known to carry antimicrobial resistance. Phylogenetic analysis confirmed their clonal relatedness, highlighting the intra-hospital dissemination of high-risk clones. Conclusions: High-risk K. pneumoniae clones, particularly ST147, pose significant challenges in healthcare settings due to the extensive antimicrobial resistance driven by plasmid-borne resistance genes, including those that co-produce carbapenemases, like blaNDM-1 and blaOXA-48. Molecular monitoring of these clones is essential for improving targeted infection control strategies, mitigating the spread of multidrug-resistant pathogens, and managing their clinical impact effectively.

Keywords: carbapenemase; clonal diffusion; molecular monitoring.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The figure shows the phylogenetic relatedness, as well as the isolation sources, the principal molecular characteristics, and the resistome, virulome, and plasmid profiles. The heatmap was created using the R package ComplexHeatmap (v.2.20.0) [10].
See this image and copyright information in PMC

References

    1. Miller W.R., Arias C.A. ESKAPE pathogens: Antimicrobial resistance, epidemiology, clinical impact and therapeutics. Nat. Rev. Microbiol. 2024;22:598–616. doi: 10.1038/s41579-024-01054-w. - DOI - PubMed
    1. Wyres K.L., Holt K.E. Klebsiella pneumoniae as a key trafficker of drug resistance genes from environmental to clinically important bacteria. Curr. Opin. Microbiol. 2018;45:131–139. doi: 10.1016/j.mib.2018.04.004. - DOI - PubMed
    1. Arcari G., Cecilia F., Oliva A., Polani R., Raponi G., Sacco F., De Francesco A., Pugliese F., Carattoli A. Genotypic Evolution of Klebsiella pneumoniae Sequence Type 512 during Ceftazidime/Avibactam, Meropenem/Vaborbactam, and Cefiderocol Treatment, Italy. Emerg. Infect. Dis. 2023;29:2266–2274. doi: 10.3201/eid2911.230921. - DOI - PMC - PubMed
    1. Navon-Venezia S., Kondratyeva K., Carattoli A. Klebsiella pneumoniae: A major worldwide source and shuttle for antibiotic resistance. FEMS Microbiol. Rev. 2017;41:252–275. doi: 10.1093/femsre/fux013. - DOI - PubMed
    1. Grundmann H., Glasner C., Albiger B., Aanensen D.M., Tomlinson C.T., Andrasević A.T., Cantón R., Carmeli Y., Friedrich A.W., Giske C.G., et al. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): A prospective, multinational study. Lancet Infect. Dis. 2017;17:153–163. doi: 10.1016/S1473-3099(16)30257-2. - DOI - PubMed

LinkOut - more resources