Klebsiella pneumoniae yersiniabactin promotes respiratory tract infection through evasion of lipocalin 2

Infect Immun. 2011 Aug;79(8):3309-16. doi: 10.1128/IAI.05114-11. Epub 2011 May 16.

Abstract

Klebsiella pneumoniae is a pathogen of increasing concern because of multidrug resistance, especially due to K. pneumoniae carbapenemases (KPCs). K. pneumoniae must acquire iron to replicate, and it utilizes iron-scavenging siderophores, such as enterobactin (Ent). The innate immune protein lipocalin 2 (Lcn2) is able to specifically bind Ent and disrupt iron acquisition. To determine whether K. pneumoniae must produce Lcn2-resistant siderophores to cause disease, we examined siderophore production by clinical isolates (n = 129) from respiratory, urine, blood, and stool samples and by defined siderophore mutants through genotyping and liquid chromatography-mass spectrometry. Three categories of K. pneumoniae isolates were identified: enterobactin positive (Ent(+)) (81%), enterobactin and yersiniabactin positive (Ent(+) Ybt(+)) (17%), and enterobactin and salmochelin (glycosylated Ent) positive (Ent(+) gly-Ent(+)) with or without Ybt (2%). Ent(+) Ybt(+) strains were significantly overrepresented among respiratory tract isolates (P = 0.0068) and β-lactam-resistant isolates (P = 0.0019), including the epidemic KPC-producing clone multilocus sequence type 258 (ST258). In ex vivo growth assays, gly-Ent but not Ybt allowed evasion of Lcn2 in human serum, whereas siderophores were dispensable for growth in human urine. In a murine pneumonia model, an Ent(+) strain was an opportunistic pathogen that was completely inhibited by Lcn2 but caused severe, disseminated disease in Lcn2(-/-) mice. In contrast, an Ent(+) Ybt(+) strain was a frank respiratory pathogen, causing pneumonia despite Lcn2. However, Lcn2 retained partial protection against disseminated disease. In summary, Ybt is a virulence factor that is prevalent among KPC-producing K. pneumoniae isolates and promotes respiratory tract infections through evasion of Lcn2.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute-Phase Proteins / antagonists & inhibitors*
  • Acute-Phase Proteins / deficiency
  • Acute-Phase Proteins / immunology
  • Animals
  • Blood / microbiology
  • DNA, Bacterial / genetics
  • Disease Models, Animal
  • Feces / microbiology
  • Humans
  • Immunologic Factors / analysis
  • Immunologic Factors / genetics
  • Immunologic Factors / metabolism*
  • Klebsiella Infections / immunology*
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / chemistry
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification
  • Klebsiella pneumoniae / pathogenicity*
  • Lipocalin-2
  • Lipocalins / antagonists & inhibitors*
  • Lipocalins / immunology
  • Mass Spectrometry
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Oncogene Proteins / antagonists & inhibitors
  • Oncogene Proteins / deficiency
  • Oncogene Proteins / immunology
  • Phenols / analysis
  • Phenols / metabolism*
  • Polymerase Chain Reaction
  • Proto-Oncogene Proteins / antagonists & inhibitors*
  • Proto-Oncogene Proteins / immunology
  • Respiratory System / microbiology
  • Respiratory Tract Infections / immunology*
  • Respiratory Tract Infections / microbiology
  • Thiazoles / analysis
  • Thiazoles / metabolism*
  • Urine / microbiology
  • Virulence
  • Virulence Factors / analysis
  • Virulence Factors / genetics
  • Virulence Factors / metabolism*

Substances

  • Acute-Phase Proteins
  • DNA, Bacterial
  • Immunologic Factors
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Oncogene Proteins
  • Phenols
  • Proto-Oncogene Proteins
  • Thiazoles
  • Virulence Factors
  • yersiniabactin
  • Lcn2 protein, mouse