Klebsiella pneumoniae (Kp) reference strain Kp52.145 is widely used in experimental Klebsiella pathophysiology. Since 1935, only one other strain of the same sublineage (sequence type ST66, capsular serotype K2) was isolated (AJ210, Australia). Here, we describe a community-acquired invasive infection caused by a ST66-K2 Kp strain in France. Four hypermucoviscous Kp isolates responsible for acute otitis media, meningitis, bacteraemia and bacteriuria, respectively, were obtained from a patient with a history of chronic alcoholism and diabetes mellitus, and infected with HIV. The isolates were characterized by phenotypic and genomic methods. The four genetically identical ST66-K2 isolates presented a full antimicrobial susceptibility profile, including to ampicillin, corresponding to a single strain (SB5881), which was more closely related to AJ210 (135 SNPs) than to Kp52.145 (388 SNPs). Colibactin and yersiniabactin gene clusters were present on the integrative and conjugative element ICEKp10 in the chromosome. The two plasmids from Kp52.145 were detected in SB5881. In addition to carrying genes for virulence factors RmpA, aerobactin and salmochelin, plasmid II has acquired in SB5881, the conjugation machinery gene cluster from plasmid I. We report the first case of community-acquired infection caused by a hypervirulent ST66-K2 Kp strain in Europe. This demonstrates the long-term persistence of the high-virulence and laboratory model ST66-K2 sublineage. The combination of a conjugative apparatus and major virulence genes on a single plasmid may contribute to the co-occurrence of hypervirulence and multidrug resistance in single Kp strains.

中文翻译：

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罕见的高毒肺炎克雷伯菌ST66-K2血统引起的社区获得性感染。

肺炎克雷伯菌 （Kp）参考菌株Kp52.145被广泛用于实验性克雷伯菌 病理生理学。自1935年以来，仅分离到了另一个亚系相同的菌株（序列类型ST66，荚膜血清型K2）（AJ210，澳大利亚）。在这里，我们描述了由法国ST66-K2 Kp菌株引起的社区获得性侵袭性感染。从患有慢性酒精中毒和糖尿病史并感染了艾滋病毒的患者中获得了四种分别负责急性中耳炎，脑膜炎，菌血症和菌尿症的高粘膜粘液Kp分离株。分离物通过表型和基因组方法表征。四个在基因上相同的ST66-K2分离株表现出完整的抗菌敏感性，包括对氨苄西林的耐药性，对应于单个菌株（SB5881），与AJ210（135 SNPs）的关系比与Kp52.145（388 SNPs）的关系更密切。染色体中的Kp 10。在SB5881中检测到来自Kp52.145的两个质粒。除了携带毒性因子RmpA，气杆菌素和沙门氏菌素的基因外，质粒II已在SB5881中获得，质粒I是缀合机制基因簇。我们报道了第一例由高毒力ST66-K2 Kp菌株引起的社区获得性感染。欧洲。这证明了高毒力和实验室模型ST66-K2子系的长期持久性。在单个质粒上结合装置和主要毒力基因的组合可能有助于在单个Kp菌株中同时出现高毒力和多药耐药性。