Open AccessColonization with Staphylococcus aureus and Klebsiella pneumoniae causes infections in a Vietnamese intensive care unit
Author(s) -
Duong Bich Thuy,
James Campbell,
Cao Thu Thuy,
Nguyễn Văn Minh Hoàng,
Phat Voong Vinh,
To Nguyen Thi Nguyen,
Chau Nguyen Ngoc Minh,
Duy Pham Thanh,
Maia A. Rabaa,
Nguyen Phu Huong Lan,
Nguyễn Văn Hảo,
Guy Thwaites,
C. Louise Thwaites,
Stephen Baker,
Nguyễn Văn Vĩnh Châu
Publication year - 2021
Publication title -
microbial genomics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.476
H-Index - 28
ISSN - 2057-5858
DOI - 10.1099/mgen.0.000514
Subject(s) - colonization , klebsiella pneumoniae , staphylococcus aureus , microbiology and biotechnology , biology , intensive care unit , methicillin resistant staphylococcus aureus , antimicrobial , intensive care , virulence , medicine , bacteria , gene , escherichia coli , intensive care medicine , genetics
Pre-existing colonization withStaphylococcus aureusorKlebsiella pneumoniaehas been found to increase the risk of infection in intensive care patients. We previously conducted a longitudinal study to characterize colonization of these two organisms in patients admitted to intensive care in a hospital in southern Vietnam. Here, using genomic and phylogenetic analyses, we aimed to assess the contribution these colonizing organisms made to infections. We found that in the majority of patients infected withS. aureusorK. pneumoniae , the sequence type of the disease-causing (infecting) isolate was identical to that of corresponding colonizing organisms in the respective patient. Further in-depth analysis revealed that in patients infected byS. aureusST188 and byK. pneumoniaeST17, ST23, ST25 and ST86, the infecting isolate was closely related to and exhibited limited genetic variation relative to pre-infection colonizing isolates. Multidrug-resistantS. aureusST188 was identified as the predominant agent of colonization and infection. Colonization and infection byK. pneumoniaewere characterized by organisms with limited antimicrobial resistance profiles but extensive repertoires of virulence genes. Our findings augment the understanding of the link between bacterial colonization and infection in a low-resource setting, and could facilitate the development of novel evidence-based approaches to prevent and treat infections in high-risk patients in intensive care.