The Norwegian Klebsiella pneumoniae network: K. pneumoniae population structure and antimicrobial resistance in a One Health perspective

Antimicrobial resistance (AMR) is a threat to the global public health. Klebsiella pneumoniae has emerged as a high-risk pathogen in humans due to the increasing levels of antibiotic resistance to our most used antibiotics, and the bacteria?s ability to cause severe disease, especially in severe ill and immunocompromised patients. Infections caused by multidrug resistant K. pneumoniae may be very challenging, and in some cases, impossible to treat. Recent outbreaks of K. pneumoniae in several Norwegian hospitals, including the neonatal intensive care unit at Stavanger University Hospital, illustrate our own vulnerability. K. pneumoniae has so far mainly been associated with hospital-acquired infections and outbreaks. However, this bacterium is ubiquitous in the environment, and may colonize and infect animals and humans. So far, K. pneumoniae has not been considered a zoonotic pathogen, and therefore not been a subject for surveys in the food production chain. Consequently, more knowledge considering the role of K. pneumoniae as a commensal in animals and humans, and the contribution of foodborne K. pneumoniae to human infection needs to be addressed. In terms of public health and food safety, such knowledge is fundamental in our approaches to elucidate transmission lines between reservoirs and containment of this important pathogen. The partners of the proposed network represent the fields of human and veterinary microbiology and medicine, environmental microbiology, and food safety. NOR-KLEB-NET will continue to enable an important cross-compartment collaboration between different sectors and with international leading scientists. NOR-KLEB-NET will focus on the evolution and spread of AMR in K. pneumoniae from a ?One Health? perspective, encompassing this pathogen?s ability to colonize and possibly disseminate between humans, animals, food, and environment ? and to cause severe and difficult to treat infections in humans and animals.

Nettverket har etablert en nettside og en twitter konto og har gjennomført to vellykkede Workshops ila prosjektperioden. Den første workshopen ble avholdt i Stavanger i mai 2018. Her var alle nettverkspartnerne samt internasjonale samarbeidspartnere (totalt 35 deltagere) samlet til en to dager workshop med faglige innlegg og diskusjoner. Ut fra nettverket og i samarbeid med nettverkets internasjonale samarbeidspartnere ble det i 2018 søkt Bergens Forskningsstiftelse om støtte til AMR One Health forskningsprosjektet KLEB-GAP (Klebsiella pneumoniae a key driver in the global spread of antimicrobial resistance and a target for new approaches in diagnostics, surveillance and alternative therapeutics). Våren 2019 fikk vi tildelt 20 mill NOK til dette prosjektet med Arnfinn Sundsfjord som PI og Iren Löhr som co-PI. I august 2019 organiserte nettverket sin andre to-dagers Workshop i Tromsø, denne gangen med 40 deltagere, inkludert 10 internasjonale gjester.

The proposed multidisciplinary network (NOR-KLEB-NET) will consist of leading national scientists in the fields of human and veterinary microbiology and medicine, environmental microbiology, food safety, and AMR-surveillance in order to study the role of AMR in K. pneumoniae in a One Health perspective. Partners of NOR-KLEB-NET, including their respective research groups and collaborators, will contribute with expertise and knowledge concerning basic microbiology, epidemiology, surveillance, carriage, infection, virulence, and AMR in this pathogen in different environmental niches (humans, animals, food, and environment). The network will enable large comparative genomic studies and surveillance of K. pneumoniae isolated from different environmental niches in order to elucidate potential crosstalk between niches. In terms of public health and food safety, the suggested network will initiate and support studies addressing K. pneumoniae in terms of zoonotic transmission and infection. Such knowledge is fundamental in our approaches to elucidate transmission lines between reservoirs and containment of this important pathogen. Establishment of NOR-KLEB-NET should result in increased national and international collaboration and applications for national (e.g. BEDREHELSE, BIONÆR, MILJØFORSK and BIOTEK2021) and international research funding (e.g. Horizon 2020, JPI-AMR, Wellcome trust and the NIH).