Transmission Dynamics and Genetic Relatedness of MDR Klebsiella pneumoniae at the Human-Animal-Environment Interface in Pakistan

Abstract

Background: K. pneumoniae is ubiquitous and known to be a notorious pathogen of human, animal, and plant-based food. K. pneumoniae is a recognized trafficker of antibiotic resistance genes (ARGs) between and from different ecological niches. Current study was designed to decipher the transmission dynamics and genetic relatedness of MDR K. pneumoniae at the human-animal-environment interface in Pakistan. \n \nMethods: A total (n=775) samples were collected from September 2017 to August 2019 from the human, animal, and environmental sources by applying the convenient random sampling technique. HiChrome Klebsiella Selective agar (Himedia®) was used for the isolation of K. pneumoniae, VITEK™ identification system (bioMerieux, France) was used isolates identification. CLSI guidelines 2018 were followed for antibiotic susceptibility testing. The range of antibiotic resistance genes (ARGs) was detected through PCR by using specific primers. Multi Locus Sequence Typing (MLST) was performed according to the Pasteur scheme and sequence types (STs) were allotted to the isolates. \n \nFindings: A total of 120 (15.7 %) samples were confirmed K. pneumoniae. The distribution of K. pneumoniae among humans, animals, and the environment were 17.4 %, 15.17%, and 7.9 % respectively. Isolates have shown significant resistance against all the subjected antibiotics except colistin. In acquired resistance genes, the highest percentage prevalence (67.5 %) of blaCTX-M was estimated in the isolates, various carbapenem resistance genes that were found in the study were blaNDM-1 (43.3%), blaOXA-48 (38 %), and (1.67 %) blaKPC-2. \n \nConclusion: Overall, 21 distinct sequence types (STs) and 13 clonal complexes (CCs) were found through the MLST analysis. Taking together, the dissemination of genetically related K. pneumoniae clones among the community is alarming for the health care system of the country. Health policymakers should consider the role of all the integral parts of human, animal, and associated environment intently to cope with this serious public and animal health concern. \n \nFunding Statement: This study was supported by grants from the major science and technology special project of Yunnan Province, No. 2019ZF004. \n \nDeclaration of Interests: All author declare No conflict of interests. \n \nEthics Approval Statement: The study was conducted in a span of two years duration from September 2017 to August 2019; proper permission was granted by the Ethical Review Board (ERB) of Government College University, Faisalabad, Pakistan.