Clonal Spread of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 in Chinese Pediatric Patients.
Clonal Spread of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 in Chinese Pediatric Patients.
复制标题
耐碳青霉烯类肺炎克雷伯菌序列11型在中国儿科患者中的克隆传播
DOI：
10.1128/spectrum.01919-22
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发表时间：
2022-12-21
影响因子：
3.7
通讯作者：
Gu, Bing
中科院分区：
文献类型：
--
作者：
Liu, Xiong;Wang, Kaiying;Chen, Jiali;Lyu, Jingwen;Li, Jinhui;Chen, Qichao;Lin, Yanfeng;Tian, Benshun;Song, Hongbin;Li, Peng;Gu, Bing
关键词：
肺炎克雷伯氏菌经常在全球范围内引起危及生命的感染。尽管它的知名度，很少知道潜在的医院暴发和传播的K。肺炎在低收入和中等收入国家的儿科患者中。98K对2018年2月至2019年5月期间从中国一家大型综合医院的儿科患者中分离的肺炎菌株进行了纳米孔和Illumina测序和基因组分析，以阐明传播和遗传多样性。K. pneumoniae中发现了序列类型11（ST 11）菌株的簇，其包括两个进化枝。大多数推断的传播都属于进化枝1，可以追溯到2017年中期的共同祖先。冠状动脉监护病房的婴儿发挥了核心作用，可能在其他病房播种传播集群。暴发期间的主要基因组变化包括与毒力相关的染色体突变以及编码抗性的质粒的获得和丧失。总之，我们报告了一个儿科患者中的医院暴发所造成的克隆传播KPC-2生产ST11 K。肺炎。我们的研究结果强调了全基因组测序在疫情调查中的价值，并说明可以在住院期间确定传播链。重要性我们报告了一个儿科患者中的医院爆发引起的克隆传播blaKPC-2携带ST11 K。肺炎。不同序列类型的菌株在复杂的医院环境中共存，ST11菌株的快速出现和传播主要是由于质粒介导的耐药基因的获得。医院感染的传播与几个特定的病房高度相关，这表明在感染高危病房进行基因组监测的重要性。
Klebsiella pneumoniae often causes life-threatening infections in patients globally. Despite its notability, little is known about potential nosocomial outbreak and spread of K. pneumoniae among pediatric patients in low- and middle-income countries. Ninety-eight K. pneumoniae strains isolated from pediatric patients in a large general hospital in China between February 2018 and May 2019 were subjected to nanopore and Illumina sequencing and genomic analysis to elucidate transmission and genetic diversity. The temporal distribution patterns of K. pneumoniae revealed a cluster of sequence type 11 (ST11) strains comprising two clades. Most inferred transmissions were of clade 1, which could be traced to a common ancestor dating to mid-2017. An infant in the coronary care unit played a central role, potentially seeding transmission clusters in other wards. Major genomic changes during the outbreak included chromosomal mutations associated with virulence and gains and losses of plasmids encoding resistance. In summary, we report a nosocomial outbreak among pediatric patients caused by clonal dissemination of KPC-2-producing ST11 K. pneumoniae. Our findings highlight the value of whole-genome sequencing during outbreak investigations and illustrate that transmission chains can be identified during hospital stays. IMPORTANCE We report a nosocomial outbreak among pediatric patients caused by clonal dissemination of blaKPC-2-carrying ST11 K. pneumoniae. Strains of various sequence types coexist in the complex hospital environment; the quick emergence and spread of ST11 strains were mainly due to the plasmid-mediated acquisition of resistance genes. The spread of hospital infection was highly associated with several specific wards, suggesting the importance of genomic surveillance on wards at high risk of infection.
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影响因子：
16.6
作者：
Lam MMC;Wick RR;Watts SC;Cerdeira LT;Wyres KL;Holt KE
通讯作者：
Holt KE
影响因子：
3.9
作者：
Kong Z;Liu X;Li C;Cheng S;Xu F;Gu B
通讯作者：
Gu B
DOI：
10.3390/antibiotics10111332
发表时间：
2021-11-01
期刊：
Antibiotics (Basel, Switzerland)
影响因子：
--
作者：
Chapelle C;Gaborit B;Dumont R;Dinh A;Vallée M
通讯作者：
Vallée M
DOI：
10.3760/cma.j.issn.0578-1310.2018.12.005
发表时间：
2018-12-02
期刊：
Zhonghua er ke za zhi = Chinese journal of pediatrics
影响因子：
--
作者：
Guo, Y;Hu, F P;Meng, J H
通讯作者：
Meng, J H
影响因子：
2.7
作者：
Kwong JC;Lane CR;Romanes F;Gonçalves da Silva A;Easton M;Cronin K;Waters MJ;Tomita T;Stevens K;Schultz MB;Baines SL;Sherry NL;Carter GP;Mu A;Sait M;Ballard SA;Seemann T;Stinear TP;Howden BP
通讯作者：
Howden BP