Cefiderocol Resistance Conferred by Plasmid-Located Ferric Citrate Transport System in KPC-Producing Klebsiella pneumoniae

Cefiderocol (FDC), a siderophore-cephalosporin conjugate, is the newest option for treating infection with carbapenem-resistant gram-negative bacteria. We identified a novel mechanism contributing to decreased FDC susceptibility in Klebsiella pneumoniae clinical isolates. The mechanism involves 2 c...

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Main Authors: Riccardo Polani, Alice De Francesco, Dario Tomolillo, Irene Artuso, Michele Equestre, Rita Trirocco, Gabriele Arcari, Guido Antonelli, Laura Villa, Gianni Prosseda, Paolo Visca, Alessandra Carattoli
Format: Article
Language:English
Published: Centers for Disease Control and Prevention 2025-01-01
Series:Emerging Infectious Diseases
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Online Access:https://wwwnc.cdc.gov/eid/article/31/1/24-1426_article
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author Riccardo Polani
Alice De Francesco
Dario Tomolillo
Irene Artuso
Michele Equestre
Rita Trirocco
Gabriele Arcari
Guido Antonelli
Laura Villa
Gianni Prosseda
Paolo Visca
Alessandra Carattoli
author_facet Riccardo Polani
Alice De Francesco
Dario Tomolillo
Irene Artuso
Michele Equestre
Rita Trirocco
Gabriele Arcari
Guido Antonelli
Laura Villa
Gianni Prosseda
Paolo Visca
Alessandra Carattoli
author_sort Riccardo Polani
collection DOAJ
description Cefiderocol (FDC), a siderophore-cephalosporin conjugate, is the newest option for treating infection with carbapenem-resistant gram-negative bacteria. We identified a novel mechanism contributing to decreased FDC susceptibility in Klebsiella pneumoniae clinical isolates. The mechanism involves 2 coresident plasmids: pKpQIL, carrying variants of blaKPC carbapenemase gene, and pKPN, carrying the ferric citrate transport (FEC) system. We observed increasing FDC MICs in an Escherichia coli model system carrying different natural pKpQIL plasmids, encoding different K. pneumoniae carbapenemase (KPC) variants, in combination with a conjugative low copy number vector carrying the fec gene cluster from pKPN. We observed transcriptional repression of fiu, cirA, fepA, and fhuA siderophore receptor genes in blaKPC–fec–E. coli cells treated with ferric citrate. Screening of 27,793 K. pneumoniae whole-genome sequences revealed that the fec cluster occurs frequently in some globally distributed different KPC-producing K. pneumoniae clones (sequence types 258, 14, 45, and 512), contributing to reduced FDC susceptibility.
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institution Kabale University
issn 1080-6040
1080-6059
language English
publishDate 2025-01-01
publisher Centers for Disease Control and Prevention
record_format Article
series Emerging Infectious Diseases
spelling doaj-art-3923f736064e45a7a29e07994ac7bc152024-12-23T13:52:36ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592025-01-0131112312410.3201/eid3101.241426Cefiderocol Resistance Conferred by Plasmid-Located Ferric Citrate Transport System in KPC-Producing Klebsiella pneumoniaeRiccardo PolaniAlice De FrancescoDario TomolilloIrene ArtusoMichele EquestreRita TriroccoGabriele ArcariGuido AntonelliLaura VillaGianni ProssedaPaolo ViscaAlessandra Carattoli Cefiderocol (FDC), a siderophore-cephalosporin conjugate, is the newest option for treating infection with carbapenem-resistant gram-negative bacteria. We identified a novel mechanism contributing to decreased FDC susceptibility in Klebsiella pneumoniae clinical isolates. The mechanism involves 2 coresident plasmids: pKpQIL, carrying variants of blaKPC carbapenemase gene, and pKPN, carrying the ferric citrate transport (FEC) system. We observed increasing FDC MICs in an Escherichia coli model system carrying different natural pKpQIL plasmids, encoding different K. pneumoniae carbapenemase (KPC) variants, in combination with a conjugative low copy number vector carrying the fec gene cluster from pKPN. We observed transcriptional repression of fiu, cirA, fepA, and fhuA siderophore receptor genes in blaKPC–fec–E. coli cells treated with ferric citrate. Screening of 27,793 K. pneumoniae whole-genome sequences revealed that the fec cluster occurs frequently in some globally distributed different KPC-producing K. pneumoniae clones (sequence types 258, 14, 45, and 512), contributing to reduced FDC susceptibility. https://wwwnc.cdc.gov/eid/article/31/1/24-1426_articleKlebsiella pneumoniaecarbapenemase-producing Klebsiella pneumoniaeKPCcefiderocolantimicrobial resistancesiderophore
spellingShingle Riccardo Polani
Alice De Francesco
Dario Tomolillo
Irene Artuso
Michele Equestre
Rita Trirocco
Gabriele Arcari
Guido Antonelli
Laura Villa
Gianni Prosseda
Paolo Visca
Alessandra Carattoli
Cefiderocol Resistance Conferred by Plasmid-Located Ferric Citrate Transport System in KPC-Producing Klebsiella pneumoniae
Emerging Infectious Diseases
Klebsiella pneumoniae
carbapenemase-producing Klebsiella pneumoniae
KPC
cefiderocol
antimicrobial resistance
siderophore
title Cefiderocol Resistance Conferred by Plasmid-Located Ferric Citrate Transport System in KPC-Producing Klebsiella pneumoniae
title_full Cefiderocol Resistance Conferred by Plasmid-Located Ferric Citrate Transport System in KPC-Producing Klebsiella pneumoniae
title_fullStr Cefiderocol Resistance Conferred by Plasmid-Located Ferric Citrate Transport System in KPC-Producing Klebsiella pneumoniae
title_full_unstemmed Cefiderocol Resistance Conferred by Plasmid-Located Ferric Citrate Transport System in KPC-Producing Klebsiella pneumoniae
title_short Cefiderocol Resistance Conferred by Plasmid-Located Ferric Citrate Transport System in KPC-Producing Klebsiella pneumoniae
title_sort cefiderocol resistance conferred by plasmid located ferric citrate transport system in kpc producing klebsiella pneumoniae
topic Klebsiella pneumoniae
carbapenemase-producing Klebsiella pneumoniae
KPC
cefiderocol
antimicrobial resistance
siderophore
url https://wwwnc.cdc.gov/eid/article/31/1/24-1426_article
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