ArticleNature microbiology2021
Pervasive transmission of a carbapenem resistance plasmid in the gut microbiota of hospitalized patients.
Article in Nature microbiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers.
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Who cites it
106 citing papers in PubMed.
- Metagenomics for antimicrobial resistance: from resistome surveillance to mechanistic inference.Journal of bacteriology · 2026Review
- Within-patient gene transfer between transiently and chronically infecting bacteria causes extreme antibiotic resistance during lung infections.Nature microbiology · 2026Article
- Modelling the role of the microbiome in antimicrobial resistance across scales.Nature microbiology · 2026Review
- Gut Hi-C metagenomes of severe COVID-19 patients: bacteria and yeast involved in gut-lung axis.mSphere · 2026Article
- Spatiotemporal genomic analysis and risk assessment of the plasmids carrying blaBMC microbiology · 2026Article
- Evaluation of Beta-Lactamase-Producing Strains Isolated in a Tertiary Nephrology Hospital in Romania.Antibiotics (Basel, Switzerland) · 2026Article
- Can machine learning support infection control measures by predicting carbapenemase-producing Enterobacterales colonization at admission?Infection control and hospital epidemiology · 2026Article
- Mechanistic insights into plasmid transfer inhibition in Enterobacterales by nucleoside analogues.npj antimicrobials and resistance · 2026Article
- Plasmids promote antimicrobial resistance through insertion sequence-mediated gene inactivation.Nature microbiology · 2026Article
- Genome sequencing for prevention of health-care-associated bacterial infections.Nature reviews. Microbiology · 2026Review
- Article
- Genomic inference of sites of transmission during regional spread of blaNature communications · 2026Article
- Regression-based modeling of pairwise genomic linkage data identifies risk factors for healthcare-associated pathogen transmission: application to carbapenem-resistantMicrobiology spectrum · 2026Article
- Molecular Insights into Carbapenem Resistance inInternational journal of molecular sciences · 2026Review
- Eco-evolutionary responses to plasmid-dependent phage constrain the spread of multidrug-resistance plasmids.The ISME journal · 2026Article
- Cooperative antibiotic resistance in bacteria: beyond biofilms.Frontiers in microbiology · 2026Review
- Differential gut transmission of IncP plasmid clades involving hypervirulent Klebsiella pneumoniae reveals plasmid-specific ecological adaptation.Nature communications · 2025Article
- ProFiT-SPEci-FISH: a novel approach for linking plasmids to hosts in complex microbial communities at the single-cell level.Microbiome · 2025Article
- Plasmid streamlining drives the extinction of antibiotic resistance plasmids under selection for horizontal transmission.PLoS biology · 2025Article
- Article
46 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
Infections caused by carbapenemase-producing enterobacteria (CPE) are a major concern in clinical settings worldwide. Two fundamentally different processes shape the epidemiology of CPE in hospitals: the dissemination of CPE clones from patient to patient (between-patient transfer), and the transfer of carbapenemase-encoding plasmids between enterobacteria in the gut microbiota of individual patients (within-patient transfer). The relative contribution of each process to the overall dissemination of carbapenem resistance in hospitals remains poorly understood. Here, we used mechanistic models combining epidemiological data from more than 9,000 patients with whole genome sequence information from 250 enterobacteria clones to characterize the dissemination routes of a pOXA-48-like carbapenemase-encoding plasmid in a hospital setting over a 2-yr period. Our results revealed frequent between-patient transmission of high-risk pOXA-48-carrying clones, mostly of Klebsiella pneumoniae and sporadically Escherichia coli. The results also identified pOXA-48 dissemination hotspots within the hospital, such as specific wards and individual rooms within wards. Using high-resolution plasmid sequence analysis, we uncovered the pervasive within-patient transfer of pOXA-48, suggesting that horizontal plasmid transfer occurs in the gut of virtually every colonized patient. The complex and multifaceted epidemiological scenario exposed by this study provides insights for the development of intervention strategies to control the in-hospital spread of CPE.
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