ArticleMicrobial genomics2019
Rapid phenotypic evolution in multidrug-resistant Klebsiella pneumoniae hospital outbreak strains.
Article in Microbial genomics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Klebsiella pneumoniae: an increasing threat to public health.Annals of clinical microbiology and antimicrobials · 2020Pooled it
- Molten salt-assisted one-pot synthesis of Ag nanoparticles supported on clay minerals for enhanced antibacterial performance.Scientific reports · 2026Article
- Clinical Epidemiological Analysis of the Genotypic Spectrum and Mortality Risk in Carbapenem-ResistantThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026Review
- Antimicrobial resistance and vaccines in Enterobacteriaceae including extraintestinal pathogenic Escherichia coli and Klebsiella pneumoniae.npj antimicrobials and resistance · 2025Review
- Article
- Inference of Infectious Disease Transmission through a Relaxed Bottleneck Using Multiple Genomes Per Host.Molecular biology and evolution · 2024Article
- Increase in antioxidant capacity associated with the successful subclone of hypervirulent carbapenem-resistant Klebsiella pneumoniae ST11-KL64.Nature communications · 2024Article
- Hybrid Sequencing-Based Genomic Analysis ofInfection and drug resistance · 2024Article
- Transiently silent acquired antimicrobial resistance: an emerging challenge in susceptibility testing.The Journal of antimicrobial chemotherapy · 2023Review
- Epidemiological characteristics ofFrontiers in microbiology · 2023Article
- Methods Combining Genomic and Epidemiological Data in the Reconstruction of Transmission Trees: A Systematic Review.Pathogens (Basel, Switzerland) · 2022Review
- NDM-1 Introduction in Portugal through a ST11 KL105Antibiotics (Basel, Switzerland) · 2022Article
- Analysis of a novel class A β-lactamase OKP-B-6 of Klebsiella quasipneumoniae: structural characterisation and interaction with commercially available drugs.Memorias do Instituto Oswaldo Cruz · 2022Article
- Evolutionary mechanisms that determine which bacterial genes are carried on plasmids.Evolution letters · 2021Article
- Genomic Epidemiology Analysis of Infectious Disease Outbreaks Using TransPhylo.Current protocols · 2021Article
- An Outbreak of Carbapenem-ResistantFrontiers in cellular and infection microbiology · 2021Article
- HypervirulentVirulence · 2020Article
- Oxacillinase-181 Carbapenemase-Producing Klebsiella pneumoniae in Neonatal Intensive Care Unit, Ghana, 2017-2019.Emerging infectious diseases · 2020Article
- Predicting Phenotypic Polymyxin Resistance in Klebsiella pneumoniae through Machine Learning Analysis of Genomic Data.mSystems · 2020Article
- Innovative and rapid antimicrobial susceptibility testing systems.Nature reviews. Microbiology · 2020Review
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 3 countries.
Funding
Abstract
Carbapenem-resistant Klebsiella pneumoniae (CRKP) increasingly cause high-mortality outbreaks in hospital settings globally. Following a patient fatality at a hospital in Beijing due to a blaKPC-2-positive CRKP infection, close monitoring was put in place over the course of 14 months to characterize all blaKPC-2-positive CRKP in circulation in the hospital. Whole genome sequences were generated for 100 isolates from blaKPC-2-positive isolates from infected patients, carriers and the hospital environment. Phylogenetic analyses identified a closely related cluster of 82 sequence type 11 (ST11) isolates circulating in the hospital for at least a year prior to admission of the index patient. The majority of inferred transmissions for these isolates involved patients in intensive care units. Whilst the 82 ST11 isolates collected during the surveillance effort all had closely related chromosomes, we observed extensive diversity in their antimicrobial resistance (AMR) phenotypes. We were able to reconstruct the major genomic changes underpinning this variation in AMR profiles, including multiple gains and losses of entire plasmids and recombination events between plasmids, including transposition of blaKPC-2. We also identified specific cases where variation in plasmid copy number correlated with the level of phenotypic resistance to drugs, suggesting that the number of resistance elements carried by a strain may play a role in determining the level of AMR. Our findings highlight the epidemiological value of whole genome sequencing for investigating multi-drug-resistant hospital infections and illustrate that standard typing schemes cannot capture the extraordinarily fast genome evolution of CRKP isolates.
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