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Whole genome sequence revealed the fine transmission map of carbapenem-resistant Klebsiella pneumonia isolates within a nosocomial outbreak.

Abstract

Background

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of nosocomial infections worldwide. The transmission route of CRKP isolates within an outbreak is rarely described. This study aimed to reveal the molecular characteristics and transmission route of CRKP isolates within an outbreak of nosocomial infection.

Methods

Collecting case information, active screening and targeted environmental monitoring were carried out. The antibiotic susceptibility, drug-resistant genes, molecular subtype and whole genome sequence of CRKP strains were analyzed.

Results

Between October and December 2011, 26 CRKP isolates were collected from eight patients in a surgical intensive care unit and subsequent transfer wards of Beijing Tongren hospital, China. All 26 isolates harbored blaKPC-2, blaSHV-1, and blaCTX-M-15 genes, had the same or similar pulsed-field gel electrophoresis patterns, and belonged to the sequence type 11 (ST11) clone. By comprehensive consideration of genomic and epidemiological information, a putative transmission map was constructed, including identifying one case as an independent event distinct from the other seven cases, and revealing two transmissions starting from the same case.

Conclusions

This study provided the first report confirming an outbreak caused by K. pneumoniae ST11 clone co-harboring the blaKPC-2, blaCTX-M-15, and blaSHV-1 genes, and suggested that comprehensive consideration of genomic and epidemiological data can yield a fine transmission map of an outbreak and facilitate the control of nosocomial transmission.

Authors+Show Affiliations

1Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China.2State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206 China. Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, Hangzhou, 310003 China.4Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015 China.1Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China.2State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206 China. Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, Hangzhou, 310003 China.1Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China.2State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206 China. Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, Hangzhou, 310003 China.1Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China.5Surgical Intensive Care Unit, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China.4Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015 China.1Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29881543

Citation

Sui, Wenjun, et al. "Whole Genome Sequence Revealed the Fine Transmission Map of Carbapenem-resistant Klebsiella Pneumonia Isolates Within a Nosocomial Outbreak." Antimicrobial Resistance and Infection Control, vol. 7, 2018, p. 70.
Sui W, Zhou H, Du P, et al. Whole genome sequence revealed the fine transmission map of carbapenem-resistant Klebsiella pneumonia isolates within a nosocomial outbreak. Antimicrob Resist Infect Control. 2018;7:70.
Sui, W., Zhou, H., Du, P., Wang, L., Qin, T., Wang, M., ... Lu, X. (2018). Whole genome sequence revealed the fine transmission map of carbapenem-resistant Klebsiella pneumonia isolates within a nosocomial outbreak. Antimicrobial Resistance and Infection Control, 7, p. 70. doi:10.1186/s13756-018-0363-8.
Sui W, et al. Whole Genome Sequence Revealed the Fine Transmission Map of Carbapenem-resistant Klebsiella Pneumonia Isolates Within a Nosocomial Outbreak. Antimicrob Resist Infect Control. 2018;7:70. PubMed PMID: 29881543.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Whole genome sequence revealed the fine transmission map of carbapenem-resistant Klebsiella pneumonia isolates within a nosocomial outbreak. AU - Sui,Wenjun, AU - Zhou,Haijian, AU - Du,Pengcheng, AU - Wang,Lijun, AU - Qin,Tian, AU - Wang,Mei, AU - Ren,Hongyu, AU - Huang,Yanfei, AU - Hou,Jing, AU - Chen,Chen, AU - Lu,Xinxin, Y1 - 2018/06/01/ PY - 2018/04/05/received PY - 2018/05/22/accepted PY - 2018/6/9/entrez PY - 2018/6/9/pubmed PY - 2019/7/31/medline KW - Carbapenemases KW - K. pneumoniae KW - KPC-2 KW - Outbreak KW - Whole genome sequencing SP - 70 EP - 70 JF - Antimicrobial resistance and infection control JO - Antimicrob Resist Infect Control VL - 7 N2 - Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of nosocomial infections worldwide. The transmission route of CRKP isolates within an outbreak is rarely described. This study aimed to reveal the molecular characteristics and transmission route of CRKP isolates within an outbreak of nosocomial infection. Methods: Collecting case information, active screening and targeted environmental monitoring were carried out. The antibiotic susceptibility, drug-resistant genes, molecular subtype and whole genome sequence of CRKP strains were analyzed. Results: Between October and December 2011, 26 CRKP isolates were collected from eight patients in a surgical intensive care unit and subsequent transfer wards of Beijing Tongren hospital, China. All 26 isolates harbored blaKPC-2, blaSHV-1, and blaCTX-M-15 genes, had the same or similar pulsed-field gel electrophoresis patterns, and belonged to the sequence type 11 (ST11) clone. By comprehensive consideration of genomic and epidemiological information, a putative transmission map was constructed, including identifying one case as an independent event distinct from the other seven cases, and revealing two transmissions starting from the same case. Conclusions: This study provided the first report confirming an outbreak caused by K. pneumoniae ST11 clone co-harboring the blaKPC-2, blaCTX-M-15, and blaSHV-1 genes, and suggested that comprehensive consideration of genomic and epidemiological data can yield a fine transmission map of an outbreak and facilitate the control of nosocomial transmission. SN - 2047-2994 UR - https://www.unboundmedicine.com/medline/citation/29881543/Whole_genome_sequence_revealed_the_fine_transmission_map_of_carbapenem_resistant_Klebsiella_pneumonia_isolates_within_a_nosocomial_outbreak_ L2 - https://aricjournal.biomedcentral.com/articles/10.1186/s13756-018-0363-8 DB - PRIME DP - Unbound Medicine ER -