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Int. J. Environ. Res. Public Health 2017, 14(10), 1169;

Tigecycline Resistant Klebsiella pneumoniae Isolated from Austrian River Water

Center for Molecular Biology, University of Vienna, 1030 Vienna, Austria
Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstrasse 2, 8010 Graz, Austria
Author to whom correspondence should be addressed.
Received: 4 September 2017 / Revised: 29 September 2017 / Accepted: 30 September 2017 / Published: 3 October 2017
(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)
PDF [302 KB, uploaded 13 October 2017]


Abstract: Antibiotic-resistant bacteria are spreading worldwide in medical settings but also in the environment. These resistant bacteria illustrate a major health problem in our times, and last-line antibiotics such as tigecycline represent an ultimate therapy option. Reports on tigecycline non-susceptible Enterobacteriaceae are presented with regard to medical settings but are rare with that for the environment. The aim of this study was to characterize two tigecycline non-susceptible Klebsiella pneumoniae isolates from the river Mur, and to question the resistance mechanism. The screening for chromosomal mutations revealed a deletion and a silent point mutation in one isolate and a point mutation in the other isolate all within the ramR allele. RamR acts as repressor and prevents overexpression of ramA. These mutations are likely to cause a resistant phenotype due to the overexpression of AcrAB-TolC. MLST revealed that the isolates belonged to two unrelated MLST types (ST2392 and ST2394). Both isolates only revealed resistance to tigecycline and tetracycline. This is one of the rare reports of tigecycline-resistant Klebsiella pneumoniae from surface water. The presence of two genetically different isolates suggests that the river water may bear substances that favor mutations that can lead to this efflux pump-driven resistance. View Full-Text
Keywords: ramA; efflux pump; multilocus sequence typing; surface water ramA; efflux pump; multilocus sequence typing; surface water
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Hladicz, A.; Kittinger, C.; Zarfel, G. Tigecycline Resistant Klebsiella pneumoniae Isolated from Austrian River Water. Int. J. Environ. Res. Public Health 2017, 14, 1169.

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