ArticleThe Journal of antimicrobial chemotherapy2017
Covert dissemination of carbapenemase-producing Klebsiella pneumoniae (KPC) in a successfully controlled outbreak: long- and short-read whole-genome sequencing demonstrate multiple genetic modes of transmission.
Article in The Journal of antimicrobial chemotherapy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
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Who cites it
52 citing papers in PubMed.
- Genomic characterization of ceftazidime/avibactam-resistant KPC-producingFrontiers in microbiology · 2026Article
- Genomic characterization ofApplied and environmental microbiology · 2025Article
- Virulence profile of carbapenem-resistantMicrobiology spectrum · 2025Article
- From Cure to Crisis: Understanding the Evolution of Antibiotic-Resistant Bacteria in Human Microbiota.Biomolecules · 2025Review
- Review
- Molecular and epidemiological characterization of carbapenem-resistant hypervirulentFrontiers in cellular and infection microbiology · 2025Article
- Resistome Analysis ofMicroorganisms · 2024Article
- Molecular epidemiology and antimicrobial resistance profiles ofFrontiers in cellular and infection microbiology · 2024Article
- Emerging challenges in antimicrobial resistance: implications for pathogenic microorganisms, novel antibiotics, and their impact on sustainability.Frontiers in microbiology · 2024Review
- Wastewater and environmental sampling holds potential for antimicrobial resistance surveillance in food-producing animals - a pilot study in South African abattoirs.Frontiers in veterinary science · 2024Article
- Plasmid genomic epidemiology ofAntimicrobial agents and chemotherapy · 2023Article
- Model-based evaluation of admission screening strategies for the detection and control of carbapenemase-producing Enterobacterales in the English hospital setting.BMC medicine · 2023Article
- Origin of Antibiotics and Antibiotic Resistance, and Their Impacts on Drug Development: A Narrative Review.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Intensive care unit sinks are persistently colonized with multidrug resistant bacteria and mobilizable, resistance-conferring plasmids.mSystems · 2023Article
- Taking hospital pathogen surveillance to the next level.Microbial genomics · 2023Article
- Dissemination of carbapenemase-producingMicrobial genomics · 2023Article
- The DNA Phosphorothioation Restriction-Modification System Influences the Antimicrobial Resistance of Pathogenic Bacteria.Microbiology spectrum · 2023Article
- Genomic Characteristics of a Multidrug-Resistant ST648Infection and drug resistance · 2023Article
- Pandemic one health clones ofFrontiers in cellular and infection microbiology · 2023Article
- Clinical and resistance characterization of carbapenem-resistantAnnals of translational medicine · 2022Article
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20 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCarbapenemase-producing Enterobacteriaceae (CPE), including KPC-producing Klebsiella pneumoniae (KPC-Kpn), are an increasing threat to patient safety.
objectivesTo use WGS to investigate the extent and complexity of carbapenemase gene dissemination in a controlled KPC outbreak. MATERIALS AND
methodsEnterobacteriaceae with reduced ertapenem susceptibility recovered from rectal screening swabs/clinical samples, during a 3 month KPC outbreak (2013-14), were investigated for carbapenemase production, antimicrobial susceptibility, variable-number-tandem-repeat profile and WGS [short-read (Illumina), long-read (MinION)]. Short-read sequences were used for MLST and plasmid/Tn4401 fingerprinting, and long-read sequence assemblies for plasmid identification. Phylogenetic analysis used IQTree followed by ClonalFrameML, and outbreak transmission dynamics were inferred using SCOTTI.
resultsTwenty patients harboured KPC-positive isolates (6 infected, 14 colonized), and 23 distinct KPC-producing Enterobacteriaceae were identified. Four distinct KPC plasmids were characterized but of 20 KPC-Kpn (from six STs), 17 isolates shared a single pKpQIL-D2 KPC plasmid. All isolates had an identical transposon (Tn4401a), except one KPC-Kpn (ST661) with a single nucleotide variant. A sporadic case of KPC-Kpn (ST491) with Tn4401a-carrying pKpQIL-D2 plasmid was identified 10 months before the outbreak. This plasmid was later seen in two other species and other KPC-Kpn (ST14,ST661) including clonal spread of KPC-Kpn (ST661) from a symptomatic case to nine ward contacts.
conclusionsWGS of outbreak KPC isolates demonstrated blaKPC dissemination via horizontal transposition (Tn4401a), plasmid spread (pKpQIL-D2) and clonal spread (K. pneumoniae ST661). Despite rapid outbreak control, considerable dissemination of blaKPC still occurred among K. pneumoniae and other Enterobacteriaceae, emphasizing its high transmission potential and the need for enhanced control efforts.
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