Whole-genome sequencing resolves a polyclonal outbreak by extended-spectrum beta-lactam and carbapenem-resistant Klebsiella pneumoniae in a Portuguese tertiary-care hospital.
Whole-genome sequencing resolves a polyclonal outbreak by extended-spectrum beta-lactam and carbapenem-resistant Klebsiella pneumoniae in a Portuguese tertiary-care hospital.
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DOI：
10.1099/mgen.0.000349
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发表时间：
2019-09
影响因子：
3.9
通讯作者：
Duarte A
中科院分区：
文献类型：
--
作者：
Perdigão J;Modesto A;Pereira AL;Neto O;Matos V;Godinho A;Phelan J;Charleston J;Spadar A;de Sessions PF;Hibberd M;Campino S;Costa A;Fernandes F;Ferreira F;Correia AB;Gonçalves L;Clark TG;Duarte A
肺炎克雷伯菌 已成为一种重要的医院病原体，全基因组测序（WGS）显着提高了我们的能力，以表征相关的爆发。我们的研究试图对多克隆的 K.肺炎 分离株（n=39; 2011年至2016年期间，在葡萄牙一家三级医疗医院发生的产超广谱β-内酰胺酶和/或碳青霉烯酶的23例患者。所有分离株均对第三代头孢菌素耐药，6株分离株（5例患者）也对碳青霉烯耐药。基于全基因组的系统发育分析揭示了一个拓扑结构，该拓扑结构代表了三个主要序列型（ST）分支（ST 15，ST 147和ST 307）的持续传播以及在不同病房的传播，与可能采取未检测到的殖民患者形式的缺失链接兼容。检测到两个碳青霉烯酶编码基因：位于Tn 4401 d转座子上的blaKPC-3和位于新型3类整合子上的blaGES-5。此外，还检测到4种编码ESBLs的基因（blaBEL-1、blaCTX-M-8、blaCTX-M-15和blaCTX-M-32）。ESBL在5个分支中的水平传播通过Tn 3样转座子上ISEcp 1上游的blaCTX-M-15基因的相似遗传环境而突出。总的来说，这项研究提供了一个高分辨率的基因组范围内的ESBL和产碳青霉烯酶的流行病学观点。 K.肺炎 在卫生保健环境中，同时促进采取适当的干预和预防战略。
Klebsiella pneumoniae has emerged as an important nosocomial pathogen, with whole-genome sequencing (WGS) significantly improving our ability to characterize associated outbreaks. Our study sought to perform a genome-wide analysis of multiclonal K. pneumoniae isolates (n=39; 23 patients) producing extended spectrum beta-lactamases and/or carbapenemases sourced between 2011 and 2016 in a Portuguese tertiary-care hospital. All isolates showed resistance to third-generation cephalosporins and six isolates (five patients) were also carbapenem resistant. Genome-wide-based phylogenetic analysis revealed a topology representing ongoing dissemination of three main sequence-type (ST) clades (ST15, ST147 and ST307) and transmission across different wards, compatible with missing links that can take the form of undetected colonized patients. Two carbapenemase-coding genes were detected: blaKPC-3 , located on a Tn4401d transposon, and blaGES-5 on a novel class 3 integron. Additionally, four genes coding for ESBLs (blaBEL-1 , blaCTX-M-8 , blaCTX-M-15 and blaCTX-M-32 ) were also detected. ESBL horizontal dissemination across five clades is highlighted by the similar genetic environments of blaCTX-M-15 gene upstream of ISEcp1 on a Tn3-like transposon. Overall, this study provides a high-resolution genome-wide perspective on the epidemiology of ESBL and carbapenemase-producing K. pneumoniae in a healthcare setting while contributing for the adoption of appropriate intervention and prevention strategies.
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影响因子：
9.5
作者：
Katoh K;Rozewicki J;Yamada KD
通讯作者：
Yamada KD
影响因子：
1.7
作者：
Bankevich, Anton;Nurk, Sergey;Pevzner, Pavel A.
通讯作者：
Pevzner, Pavel A.
影响因子：
6.5
作者：
Anisimova, Maria;Gascuel, Olivier
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Gascuel, Olivier
影响因子：
14.9
作者：
Letunic, Ivica;Bork, Peer
通讯作者：
Bork, Peer
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