ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Long-term Persistence of an Extensively Drug-Resistant Subclade of Globally Distributed Pseudomonas aeruginosa Clonal Complex 446 in an Academic Medical Center.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prioritization of Critical Factors for Surveillance of the Dissemination of Antibiotic Resistance inInternational journal of molecular sciences · 2023Pooled it
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- Comparison ofbioRxiv : the preprint server for biology · 2026Article
- Role of R5 pyocin in the predominance of high-risk Pseudomonas aeruginosa isolates.Microbiological research · 2025Article
- Unveiling a hidden threat: whole genome sequencing exposes the cross-hospital spread of extensively drug-resistantFrontiers in microbiology · 2025Article
- Impact of multidrug resistance on the virulence and fitness of Pseudomonas aeruginosa: a microbiological and clinical perspective.Infection · 2024Review
- Rapid typing ofFrontiers in microbiology · 2024Article
- Taxonomic characterization ofMicrobiology spectrum · 2023Article
- Whole-genome sequencing reveals high-risk clones ofFrontiers in microbiology · 2023Article
- Functional and Structural Characterization of OXA-935, a Novel OXA-10-Family β-Lactamase from Pseudomonas aeruginosa.Antimicrobial agents and chemotherapy · 2022Article
- Genomic-based transmission analysis of carbapenem-resistantJAC-antimicrobial resistance · 2022Article
- What makes a megaplasmid?Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2022Article
- Epidemic Territorial Spread of IncP-2-Type VIM-2 Carbapenemase-Encoding Megaplasmids in Nosocomial Pseudomonas aeruginosa Populations.Antimicrobial agents and chemotherapy · 2021Article
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12 authors.
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Abstract
backgroundAntimicrobial resistance (AMR) is a major challenge in the treatment of infections caused by Pseudomonas aeruginosa. Highly drug-resistant infections are disproportionally caused by a small subset of globally distributed P. aeruginosa sequence types (STs), termed "high-risk clones." We noted that clonal complex (CC) 446 (which includes STs 298 and 446) isolates were repeatedly cultured at 1 medical center and asked whether this lineage might constitute an emerging high-risk clone.
methodsWe searched P. aeruginosa genomes from collections available from several institutions and from a public database for the presence of CC446 isolates. We determined antibacterial susceptibility using microbroth dilution and examined genome sequences to characterize the population structure of CC446 and investigate the genetic basis of AMR.
resultsCC446 was globally distributed over 5 continents. CC446 isolates demonstrated high rates of AMR, with 51.9% (28/54) being multidrug-resistant (MDR) and 53.6% of these (15/28) being extensively drug-resistant (XDR). Phylogenetic analysis revealed that most MDR/XDR isolates belonged to a subclade of ST298 (designated ST298*) of which 100% (21/21) were MDR and 61.9% (13/21) were XDR. XDR ST298* was identified repeatedly and consistently at a single academic medical center from 2001 through 2017. These isolates harbored a large plasmid that carries a novel antibiotic resistance integron.
conclusionsCC446 isolates are globally distributed with multiple occurrences of high AMR. The subclade ST298* is responsible for a prolonged epidemic (≥16 years) of XDR infections at an academic medical center. These findings indicate that CC446 is an emerging high-risk clone deserving further surveillance.
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