Emergence of multidrug-resistant Klebsiella pneumoniae in wild animals in Africa

Klebsiella pneumoniae, responsible for a range of infections, poses a considerable public health threat because of its wide distribution and propensity for antimicrobial resistance (AMR).1Zou H Zhou Z Berglund B et al.Persistent transmission of carbapenem-resistant, hypervirulent Klebsiella pneumoniae between a hospital and urban aquatic environments.Water Res. 2023; 242120263Crossref Scopus (2) Google Scholar In a recent article published in The Lancet Microbe, Jessica K Calland and colleagues2Calland JK Haukka K Kpordze SW et al.Population structure and antimicrobial resistance among Klebsiella isolates sampled from human, animal, and environmental sources in Ghana: a cross-sectional genomic One Health study.Lancet Microbe. 2023; 4: e943-e952Summary Full Text Full Text PDF PubMed Google Scholar used a One Health approach to investigate K pneumoniae isolates from human, animal, and environmental sources in Ghana, Africa, and identified 370 isolates, with two carbapenem-resistant isolates originating from a hospital source. Their results showed the presence of multidrug resistance-associated and virulence-associated genes in Klebsiella isolates from various sources and regions. However, wild animals are a potential source of Klebsiella infection and can be easily neglected. In 2019, we collected 53 faecal samples from giraffes, elephants, rhinos, and horses imported from Africa before they entered China. From an elephant faecal sample in Zimbabwe, two carbapenem-resistant K pneumoniae isolates, DX3-2hy and DX2-3hy, were isolated, and they showed resistance to imipenem, meropenem, aztreonam, ceftriaxone, cefotaxime, ceftazidime, levofloxacin, ciprofloxacin, amikacin, gentamicin, piperacillin–tazobactam, fosfomycin–D-glucose-6, chloramphenicol, amoxicillin–clavulanate, cefepime, omadacycline, and eravacycline but not to ceftazidime–avibactam, polymyxin B, and tigecycline. Complete genome sequencing revealed an average nucleotide identity of 99·98% between the DX3-2hy and DX2-3hy isolates, suggesting a common origin. Multilocus sequence typing revealed that both isolates belonged to ST11, a widespread sequence type observed worldwide.3Wyres KL Lam MMC Holt KE Population genomics of Klebsiella pneumoniae.Nat Rev Microbiol. 2020; 18: 344-359Crossref PubMed Scopus (403) Google Scholar Furthermore, both isolates had a multidrug-resistant IncFII (pHN7A8)/IncR plasmid (pKPC-2) that harboured several AMR-associated genes, including blaKPC-2, blaCTX-M-65, rmtB, blaSHV-12, and blaTEM-1B. The carbapenemase-encoding gene blaKPC-2 was located within an IS26-ISKpn27-blaKPC-2-ISKpn6 array, which is highly similar to other plasmids worldwide, thus indicating its potential contribution to horizontal gene transfer (appendix p 1). The adoption of the One Health approach to understand AMR and its drivers has led to increased research on the ecology of K pneumoniae. Ecological studies and cross-niche surveillance have shed light on major animal, food, and environmental reservoirs of K pneumoniae. However, most studies have overlooked wild animals because of their limited human contact.4Ludden C Moradigaravand D Jamrozy D et al.A one health study of the genetic relatedness of Klebsiella pneumoniae and their mobile elements in the east of England.Clin Infect Dis. 2020; 70: 219-226Crossref PubMed Scopus (37) Google Scholar The increase in multidrug-resistant K pneumoniae in wildlife suggests that wild animals might play a role in disseminating resistance genes. Our study underscores the urgency of enhanced global surveillance for wildlife-related AMR. We declare no competing interests. This work was supported by the National Key R&D Program of China (2020YFE0204300) and the National Natural Science Foundation of China (82072314). Download .pdf (14.31 MB) Help with pdf files Supplementary appendix