ArticleAntimicrobial agents and chemotherapy2015
Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae at a single institution: insights into endemicity from whole-genome sequencing.
Article in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 94 papers, 1 of them a synthesis that pooled it.
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Who cites it
94 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States.Antimicrobial resistance and infection control · 2018Pooled it
- The Evolving Clonal, Plasmid-Mediated Resistome, Virulome and Therapeutic Landscape of Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2026Article
- Clonal dissemination and plasmid plasticity of KPC-3-producing Klebsiella pneumoniae ST512 during a hospital outbreak in Spain.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- National genomic surveillance reveals global plasmid and chromosomal dissemination routes of blanpj antimicrobials and resistance · 2026Article
- Disinfection of hospital sink drains enriches pseudomonadota and efflux pump-mediated antibiotic resistance in reestablished biofilms.Nature communications · 2026Article
- Resistance, Virulence, and Molecular Epidemiology of Carbapenem-ResistantMicroorganisms · 2026Article
- Article
- Challenges and considerations for whole-genome-based antimicrobial resistance plasmid investigations.Antimicrobial agents and chemotherapy · 2025Review
- Disinfection of Hospital Sink Drains Enriches Pseudomonadota and Efflux Pump-Mediated Antibiotic Resistance in Reestablished Biofilms.Research square · 2025Article
- Genomic tracing and resolution of environmental Klebsiella pneumoniae ST307 CTX-M-15 linked to a nosocomial urinary tract infection in a cat: a veterinary teaching hospital case study.BMC veterinary research · 2025Article
- Plasmids, a molecular cornerstone of antimicrobial resistance in the One Health era.Nature reviews. Microbiology · 2024Review
- Developing a framework for tracking antimicrobial resistance gene movement in a persistent environmental reservoir.npj antimicrobials and resistance · 2024Article
- Worldwide transmission of ST11-KL64 carbapenem-resistantmSphere · 2023Article
- Distinct Origins and Transmission Pathways ofJournal of clinical microbiology · 2023Article
- Multicentre genetic diversity study of carbapenem-resistant Enterobacterales: predominance of untypeable pUVA-likeJAC-antimicrobial resistance · 2023Article
- Dissemination of carbapenemase-producingMicrobial genomics · 2023Article
- Rapid adaptations ofMicrobial genomics · 2023Article
- Ceftazidime-avibactam resistance inMicrobial genomics · 2023Article
- Transmission of Carbapenem-Resistant Klebsiella pneumoniae in US Hospitals.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Article
34 more citing papers are in PubMed but not listed here.
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13 authors.
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Abstract
The global emergence of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) multilocus sequence type ST258 is widely recognized. Less is known about the molecular and epidemiological details of non-ST258 K. pneumoniae in the setting of an outbreak mediated by an endemic plasmid. We describe the interplay of blaKPC plasmids and K. pneumoniae strains and their relationship to the location of acquisition in a U.S. health care institution. Whole-genome sequencing (WGS) analysis was applied to KPC-Kp clinical isolates collected from a single institution over 5 years following the introduction of blaKPC in August 2007, as well as two plasmid transformants. KPC-Kp from 37 patients yielded 16 distinct sequence types (STs). Two novel conjugative blaKPC plasmids (pKPC_UVA01 and pKPC_UVA02), carried by the hospital index case, accounted for the presence of blaKPC in 21/37 (57%) subsequent cases. Thirteen (35%) isolates represented an emergent lineage, ST941, which contained pKPC_UVA01 in 5/13 (38%) and pKPC_UVA02 in 6/13 (46%) cases. Seven (19%) isolates were the epidemic KPC-Kp strain, ST258, mostly imported from elsewhere and not carrying pKPC_UVA01 or pKPC_UVA02. Using WGS-based analysis of clinical isolates and plasmid transformants, we demonstrate the unexpected dispersal of blaKPC to many non-ST258 lineages in a hospital through spread of at least two novel blaKPC plasmids. In contrast, ST258 KPC-Kp was imported into the institution on numerous occasions, with other blaKPC plasmid vectors and without sustained transmission. Instead, a newly recognized KPC-Kp strain, ST941, became associated with both novel blaKPC plasmids and spread locally, making it a future candidate for clinical persistence and dissemination.
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