ArticlePloS one2013
A long-term low-frequency hospital outbreak of KPC-producing Klebsiella pneumoniae involving Intergenus plasmid diffusion and a persisting environmental reservoir.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 1 of them a synthesis that pooled it.
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Who cites it
68 citing papers in PubMed, 1 synthesis or guideline pooled it, 126 citations in OpenAlex.
- Epidemic potential of Escherichia coli ST131 and Klebsiella pneumoniae ST258: a systematic review and meta-analysis.BMJ open · 2016Pooled it
- Advancements in Technologies Targeting Horizontal Gene TransferRoutes to Control Drug Resistance Evolution.ACS bio & med chem Au · 2026Review
- The clonality and dissemination of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital in Malaysia: a retrospective analysis from 2022 to 2023.Osong public health and research perspectives · 2026Article
- Biofilm removal in hospital sink drains drives unintended surges in antibiotic resistance.npj antimicrobials and resistance · 2026Article
- Nationwide genomic surveillance of carbapenem- and colistin-resistant Klebsiella pneumoniae bloodstream isolates in Thailand (2020-2024).Scientific reports · 2026Article
- The hospital sink drain microbiome as a melting pot for AMR transmission to nosocomial pathogens.npj antimicrobials and resistance · 2025Review
- Plasmid Dissemination in Multispecies Carbapenemase-Producing Enterobacterales Outbreaks Involving Clinical and Environmental Strains: A Narrative Review.Microorganisms · 2025Review
- Hospital toilets and drainage systems as a reservoir for a long-term polyclonal outbreak of clinical infections with multidrug-resistantInfection prevention in practice · 2025Article
- Carbapenemase producingInfection prevention in practice · 2024Article
- Outbreak of carbapenemase-producingEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024Article
- Concurrent transmission of multiple carbapenemases in a long-term acute-care hospital.Infection control and hospital epidemiology · 2024Review
- Identification of carbapenem-resistant organism (CRO) contamination of in-room sinks in intensive care units in a new hospital bed tower.Infection control and hospital epidemiology · 2024Observational
- Plasmids, a molecular cornerstone of antimicrobial resistance in the One Health era.Nature reviews. Microbiology · 2024Review
- Impact of intense sanitization on environmental biofilm communities and the survival ofFrontiers in microbiology · 2024Article
- Plasmid genomic epidemiology ofAntimicrobial agents and chemotherapy · 2023Article
- Intraregional hospital outbreak of OXA-244-producingEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2023Article
- Empirically derived sequence similarity thresholds to study the genomic epidemiology of plasmids shared among healthcare-associated bacterial pathogens.EBioMedicine · 2023Observational
- Outbreak of OXA-48-producing Enterobacteriaceae in a neonatal intensive care unit in Western Sweden.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
- Highlighting extended-spectrum beta-lactamase-producingHeliyon · 2023Article
- Article
8 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo study the molecular characteristics of a long-term, low frequency outbreak of bla KPC-2 in a low prevalence setting involving the hospital environment. METHODOLOGY/PRINCIPAL
findingsKPC-producing bacteria were screened by selective chromogenic agar and Real-Time PCR. The presence of antibiotic resistance genes was ascribed by PCRs and subsequent sequencing, and the KPC-producing isolates were phylogenetically typed using PFGE and multi-locus sequence typing. Bla KPC-2-plasmids were identified and analysed by S1-nuclease-PFGE hybridization and PCR based replicon typing. A ∼97 kb IncFII plasmid was seen to carry bla KPC-2 in all of the clinical isolates, in one of the isolates recovered from screened patients (1/136), and in the Klebsiella pneumoniae and Enterobacter asburiae isolates recovered from the environment (sinks) in one intensive care unit. The K. pneumoniae strain ST258 was identified in 6 out of 7 patients. An intergenus spread to E. asburiae and an interspecies spread to two different K. pneumoniae clones (ST27 and ST461) of the bla KPC-2 plasmid was discovered. K. pneumoniae ST258 and genetically related E. asburiae strains were found in isolates of both human and environmental origins. CONCLUSIONS/SIGNIFICANCE: We document a clonal transmission of the K. pneumoniae ST258 strain, and an intergenus plasmid diffusion of the IncFII plasmid carrying bla KPC-2 in this outbreak. A major reservoir in the patient population could not be unveiled. However, the identification of a persisting environmental reservoir of strains with molecular determinants linked to human isolates, suggests a possible role of the environment in the maintenance of this long-term outbreak.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.