ArticleAntimicrobial agents and chemotherapy2017
A Prolonged Outbreak of KPC-3-Producing Enterobacter cloacae and Klebsiella pneumoniae Driven by Multiple Mechanisms of Resistance Transmission at a Large Academic Burn Center.
Article in Antimicrobial agents and chemotherapy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers.
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Who cites it
49 citing papers in PubMed, 79 citations in OpenAlex.
- 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
- Challenges in Antimicrobial Treatment and Antimicrobial Stewardship in Hospital-Acquired Infections in Adult Burn Patients.European burn journal · 2026Review
- Genomic inference of sites of transmission during regional spread of blaNature communications · 2026Article
- Unprecedented Polymicrobial Bacteremia With Nine Microorganisms in a Critically Ill 95% Burn Patient.Cureus · 2025Article
- A network analysis of carbapenem-resistant Klebsiella pneumoniae among healthcare facilities.Scientific reports · 2025Observational
- Carbapenem-resistant Enterobacterales infection and colonization in patients with severe burns: a retrospective cohort study in a single burn center.Antimicrobial resistance and infection control · 2025Article
- Aztreonam Acts as a Synergist for Ceftazidime/Avibactam Against Carbapenem-ResistantInfection and drug resistance · 2025Article
- Epidemiology of carbapenem-resistant organisms in Alameda County, California, 2019-2021.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- #AMRrounds: a systematic educational approach for navigating bench to bedside antimicrobial resistance.JAC-antimicrobial resistance · 2023Review
- Burden of severe infections due to carbapenem-resistant pathogens in intensive care unit.World journal of clinical cases · 2023Review
- Dissemination of carbapenemase-producingMicrobial genomics · 2023Article
- Multidrug-Resistant Pathogens in Burn Wound, Prevention, Diagnosis, and Therapeutic Approaches (Conventional Antimicrobials and Nanoparticles).The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2023Review
- Recent Approaches for Downplaying Antibiotic Resistance: Molecular Mechanisms.BioMed research international · 2023Review
- Clinical epidemiology of carbapenem-resistant Enterobacterales in the Greater Houston region of Texas: a 6-year trend and surveillance analysis.Journal of global antimicrobial resistance · 2022Observational
- Clinical and Genomic Epidemiology ofMicrobiology spectrum · 2022Article
- Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales.Nature communications · 2022Article
- Global Threat of Carbapenem-Resistant Gram-Negative Bacteria.Frontiers in cellular and infection microbiology · 2022Review
- Characterization ofJAC-antimicrobial resistance · 2021Article
- Pathophysiological effects of Klebsiella pneumoniae infection on Galleria mellonella as an invertebrate model organism.Archives of microbiology · 2021Article
- Institutional outbreak involving multiple clades of IMP-producing Enterobacter cloacae complex sequence type 78 at a cancer center in Tokyo, Japan.BMC infectious diseases · 2021Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacter cloacae has been recently recognized in the United States. Whole-genome sequencing (WGS) has become a useful tool for analysis of outbreaks and for determining transmission networks of multidrug-resistant organisms in health care settings, including carbapenem-resistant Enterobacteriaceae (CRE). We experienced a prolonged outbreak of CRE E. cloacae and K. pneumoniae over a 3-year period at a large academic burn center despite rigorous infection control measures. To understand the molecular mechanisms that sustained this outbreak, we investigated the CRE outbreak isolates by using WGS. Twenty-two clinical isolates of CRE, including E. cloacae (n = 15) and K. pneumoniae (n = 7), were sequenced and analyzed genetically. WGS revealed that this outbreak, which seemed epidemiologically unlinked, was in fact genetically linked over a prolonged period. Multiple mechanisms were found to account for the ongoing outbreak of KPC-3-producing E. cloacae and K. pneumoniae This outbreak was primarily maintained by a clonal expansion of E. cloacae sequence type 114 (ST114) with distribution of multiple resistance determinants. Plasmid and transposon analyses suggested that the majority of bla
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