| Titre : | Drivers of Antimicrobial Resistance in Klebsiella pneumoniae |
| Auteurs : | Alyssa Nicole Marina B. Jamora ; Ecole des hautes études en santé publique (EHESP) (Rennes, FRA) |
| Type de document : | Mémoire |
| Année de publication : | 2025 |
| Description : | 46p. |
| Langues: | Anglais |
| Classement : | MPH/ (Mémoires MPH à partir de 2024) |
| Mots-clés : | Pharmacorésistance ; Médicament antibiotique ; Klebsiella ; Gène |
| Résumé : |
Antimicrobial resistance (AMR) is a growing public health threat with wide-ranging implications. A major concern is the increasing prevalence of beta-lactamase enzymes. Beta-lactamases particularly extended-spectrum beta-lactamases (ESBLs) and carbapenemases, have become a central focus in the fight against AMR due to their rapid emergence and global spread. Klebsiella pneumoniae is a major driver of this resistance because of its ability to acquire and disseminate beta-lactamase genes through plasmids. This study investigated the global distribution of beta-lactamase-carrying plasmids in K. pneumoniae, using 2,074 complete genomes from NCBI RefSeq and their associated metadata from Genbank. Resistance genes were detected using AMRFinderPlus, while plasmids types and features were identified using a new in-house typing framework. The majority of antibiotic resistance genes (68.7%) were plasmid-borne, with beta-lactamases showing the highest gene diversity and frequency. Among 7,147 plasmids identified, 2,827 (39.6%) carried at least one beta-lactamase genes and most of which were conjugative. A total of 224 plasmid types were identified and 95 were linked to beta-lactamase carriage. Few plasmid types exclusively carried either ESBL or cabapenemase genes, while most were shared across resistance subtypes. Statistical analyses revealed strong associations between plasmid types and resistance subgroups, with significant geographic structuring.
For instance, plasmid type 333 was exclusively linked to carbapenemase carriage in Asia, while 276 was more predominant in Europe. Logistic regression models with interaction terms confirmed that plasmid–resistance associations varied significantly by continent. Sequence alignment of the identified carbapenemase-carrying plasmids in Asia (333) and Europe (276) showed distinct genetic backbones, supporting the idea that different plasmid lineages are driving resistance in different regions. These findings highlight the role of plasmids in the global dissemination of beta-lactamase genes. Understanding which plasmid types are common in each region could help guide more targeted interventions in the ongoing fight against AMR. |
| Diplôme : | Master MPH of public health |
| Plan de classement simplifié : | Master of Public Health - master international de Santé Publique (MPH) |
| En ligne : | https://documentation.ehesp.fr/memoires/2025/mph/alyssa_nicole_marina_jamora.pdf |
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