Covert dissemination of carbapenemase-producing Klebsiella pneumoniae (KPC) in a successfully controlled outbreak: long- and short-read whole-genome sequencing demonstrate multiple genetic modes of transmission
| العنوان: | Covert dissemination of carbapenemase-producing Klebsiella pneumoniae (KPC) in a successfully controlled outbreak: long- and short-read whole-genome sequencing demonstrate multiple genetic modes of transmission |
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| المؤلفون: | Jane F. Turton, Robert Hill, Andrew Kirby, Jacqueline Findlay, Nicola De Maio, Hang T. T. Phan, Indre Navickaite, Derrick W. Crook, Tim E. A. Peto, Nicola Young, Mark H. Wilcox, Louise Pankhurst, Nicolas M. Orsi, David W Eyre, Jessica Martin, Neil Woodford, Katie L. Hopkins, Nicole Stoesser, A. Sarah Walker, Giles J. Toogood |
| المصدر: | Martin, J, Phan, H T T, Findlay, J, Stoesser, N, Pankhurst, L, Navickaite, I, De Maio, N, Eyre, D W, Toogood, G, Orsi, N M, Kirby, A, Young, N, Turton, J F, Hill, R L R, Hopkins, K L, Woodford, N, Peto, T E A, Walker, A S, Crook, D W & Wilcox, M H 2017, ' Covert dissemination of carbapenemase-producing Klebsiella pneumoniae (KPC) in a successfully controlled outbreak : long-and short-read whole-genome sequencing demonstrate multiple genetic modes of transmission ', Journal of Antimicrobial Chemotherapy, vol. 72, no. 11, pp. 3025-3034 . https://doi.org/10.1093/jac/dkx264 Journal of Antimicrobial Chemotherapy |
| بيانات النشر: | Oxford University Press (OUP), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, DNA, Bacterial, Male, 0301 basic medicine, Microbiology (medical), Gene Transfer, Horizontal, Sequence analysis, Klebsiella pneumoniae, 030106 microbiology, Biology, beta-Lactamases, Disease Outbreaks, Microbiology, 03 medical and health sciences, chemistry.chemical_compound, Plasmid, Bacterial Proteins, Enterobacteriaceae, Journal Article, polycyclic compounds, Humans, Pharmacology (medical), Phylogeny, Aged, Original Research, Pharmacology, Whole genome sequencing, Cross Infection, Whole Genome Sequencing, Outbreak, Sequence Analysis, DNA, Middle Aged, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Virology, United Kingdom, Klebsiella Infections, Infectious Diseases, chemistry, Multilocus sequence typing, Female, Ertapenem, Genome, Bacterial, Multilocus Sequence Typing, Plasmids |
| الوصف: | Background Carbapenemase-producing Enterobacteriaceae (CPE), including KPC-producing Klebsiella pneumoniae (KPC-Kpn), are an increasing threat to patient safety. Objectives To use whole-genome sequencing (WGS) to investigate the extent and complexity of carbapenemase gene dissemination in a controlled KPC outbreak. Materials/methods Enterobacteriaceae with reduced ertapenem susceptibility recovered from rectal screening swabs/clinical samples, during a three-month KPC outbreak (2013-14), were investigated for carbapenemase production, antimicrobial susceptibility, VNTR profile and WGS (short-read [Illumina], long-read [MinION]). Short-read sequences were used for MLST and plasmid/Tn4401 fingerprinting, and long-read sequence assemblies for plasmid identification. Phylogenetic analysis used IQTree followed by ClonalFrameML and outbreak transmission dynamics were inferred using SCOTTI. Results Twenty patients harboured KPC-positive isolates (6 infected, 14 colonised), and 23 distinct KPC-producing Enterobacteriaceae were identified. Four distinct KPC plasmids were characterised but of 20 KPC-Kpn (from six STs), 17 isolates shared a single pKpQIL-D2 KPC plasmid. All isolates had an identical transposon (Tn4401a), except one KPC-Kpn (ST661) with a single nucleotide variant. A sporadic case of KPC-Kpn(ST491) with Tn4401a-carrying pKpQIL-D2 plasmid was identified 10 months before the outbreak. This plasmid was later seen in two other species and other KPC-Kpn(ST14,ST661) including clonal spread of KPC-Kpn(ST661) from a symptomatic case to 9 ward contacts. Conclusions WGS of outbreak KPC isolates demonstrated blaKPC dissemination via horizontal transposition (Tn4401a), plasmid spread (pKpQIL-D2) and clonal spread (K. pneumoniae ST661). Despite rapid outbreak control, considerable dissemination of blaKPC still occurred among K. pneumoniae and other Enterobacteriaceae, emphasising its high transmission potential and the need for enhanced control efforts. |
| وصف الملف: | application/pdf |
| تدمد: | 1460-2091 0305-7453 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4476543be009e478ad6138a5de32814d https://doi.org/10.1093/jac/dkx264 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....4476543be009e478ad6138a5de32814d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14602091 03057453 |
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