ArticlePloS one2020
Within-patient plasmid dynamics in Klebsiella pneumoniae during an outbreak of a carbapenemase-producing Klebsiella pneumoniae.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Within-patient carbapenem heteroresistance inCurrent research in microbial sciences · 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
- Genomic characterization of multidrug-resistant Klebsiella pneumoniae clinical isolates from India.Scientific reports · 2026Article
- Closely related ST11Frontiers in immunology · 2026Article
- The dark matter of bacterial genomic surveillance-antimicrobial resistance plasmid transmissions in the hospital setting.Journal of clinical microbiology · 2025Article
- Article
- Plasmid genomic epidemiology ofAntimicrobial agents and chemotherapy · 2023Article
- ISMicrobial genomics · 2022Article
- Simultaneous gut colonization by Klebsiella grimontii and Escherichia coli co-possessing the blaEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- NGSocomial Infections: High-Resolution Views of Hospital-Acquired Infections Through Genomic Epidemiology.Journal of the Pediatric Infectious Diseases Society · 2021Review
- Context-aware genomic surveillance reveals hidden transmission of a carbapenemase-producingMicrobial genomics · 2021Article
- Putative mobilized colistin resistance genes in the human gut microbiome.BMC microbiology · 2021Article
- DistinguishingAntimicrobial agents and chemotherapy · 2021Article
- Acquisition of Tigecycline Resistance by Carbapenem-ResistantFrontiers in microbiology · 2021Article
- Detection of extended-spectrum beta-lactamase (ESBL) genes and plasmid replicons inMicrobial genomics · 2020Article
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5 authors.
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Abstract
introductionKnowledge of within-patient dynamics of resistance plasmids during outbreaks is important for understanding the persistence and transmission of plasmid-mediated antimicrobial resistance. During an outbreak of a Klebsiella pneumoniae carbapenemase-producing (KPC) K. pneumoniae, the plasmid and chromosomal dynamics of K. pneumoniae within-patients were investigated.
methodsDuring the outbreak, all K. pneumoniae isolates of colonized or infected patients were collected, regardless of their susceptibility pattern. A selection of isolates was short-read and long-read sequenced. A hybrid assembly of the short-and long-read sequence data was performed. Plasmid contigs were extracted from the hybrid assembly, annotated, and within patient plasmid comparisons were performed.
resultsFifteen K. pneumoniae isolates of six patients were short-read whole-genome sequenced. Whole-genome multi-locus sequence typing revealed a maximum of 4 allele differences between the sequenced isolates. Within patients 1 and 2 the resistance gene- and plasmid replicon-content did differ between the isolates sequenced. Long-read sequencing and hybrid assembly of 4 isolates revealed loss of the entire KPC-gene containing plasmid in the isolates of patient 2 and a recombination event between the plasmids in the isolates of patient 1. This resulted in two different KPC-gene containing plasmids being simultaneously present during the outbreak.
conclusionDuring a hospital outbreak of a KPC-producing K. pneumoniae isolate, plasmid loss of the KPC-gene carrying plasmid and plasmid recombination was detected within the isolates from two patients. When investigating outbreaks, one should be aware that plasmid transmission can occur and the possibility of within- and between-patient plasmid variation needs to be considered.
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