ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Genome Sequencing Identifies Previously Unrecognized Klebsiella pneumoniae Outbreaks in Neonatal Intensive Care Units in the Philippines.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Surveillance of antibiotic-resistant bacteria integrating whole genome sequencing and epidemiological information - a global, systematic review, 2012-2023.Antimicrobial resistance and infection control · 2026Pooled it
- ISEmerging microbes & infections · 2026Article
- Emergence of gene associations in high-risk K. pneumoniae clones: blaArchives of microbiology · 2026Article
- Characterization of KPC-160, a novel Ω-loop-deleted KPC variant on a dual-copy plasmid that confers cefiderocol resistance.Antimicrobial agents and chemotherapy · 2026Article
- Prospective genomic and epidemiologic surveillance of Klebsiella pneumoniae in a tertiary NICU.Antimicrobial resistance and infection control · 2026Article
- Operationalising Genomic Surveillance for Antimicrobial Resistance in Low- and Middle-Income Countries: A One Health Perspective from Bangladesh.Microorganisms · 2026Review
- Integrated epidemiologic investigation and genomic confirmation of a Klebsiella pneumoniae neonatal sepsis outbreak in Botswana.PLOS global public health · 2026Article
- ConfrontingInfection and drug resistance · 2026Review
- Draft genome sequences of selectedMicrobiology resource announcements · 2025Article
- Coexistence of blaScientific reports · 2025Article
- Identification of a novel phage depolymerase against ST11 K64 carbapenem-resistantJournal of bacteriology · 2025Article
- Recovery of clinically relevant multidrug-resistant Klebsiella pneumoniae lineages from wastewater in Kumasi Metropolis, Ghana.Environmental microbiology reports · 2024Article
- Antimicrobial resistance profiles and genome characteristics ofJournal of medical microbiology · 2024Article
- Comparison of carbapenem-susceptible and carbapenem-resistantMicrobial genomics · 2023Article
- Clinically Isolated β-Lactam-Resistant Gram-Negative Bacilli in a Philippine Tertiary Care Hospital Harbor Multi-Class β-Lactamase Genes.Pathogens (Basel, Switzerland) · 2023Article
- Maternal Colonization Versus Nosocomial Transmission as the Source of Drug-Resistant Bloodstream Infection in an Indian Neonatal Intensive Care Unit: A Prospective Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Clinical and Microbiological Characteristics ofInfection and drug resistance · 2023Article
- Article
- Implementing Whole-Genome Sequencing for Ongoing Surveillance of Antimicrobial Resistance: Exemplifying Insights Into Klebsiella pneumoniae.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Clones and Clusters of Antimicrobial-Resistant Klebsiella From Southwestern Nigeria.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
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Authors and funding
18 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundKlebsiella pneumoniae is a critically important pathogen in the Philippines. Isolates are commonly resistant to at least 2 classes of antibiotics, yet mechanisms and spread of its resistance are not well studied.
methodsA retrospective sequencing survey was performed on carbapenem-, extended spectrum beta-lactam-, and cephalosporin-resistant Klebsiella pneumoniae isolated at 20 antimicrobial resistance (AMR) surveillance sentinel sites from 2015 through 2017. We characterized 259 isolates using biochemical methods, antimicrobial susceptibility testing, and whole-genome sequencing (WGS). Known AMR mechanisms were identified. Potential outbreaks were investigated by detecting clusters from epidemiologic, phenotypic, and genome-derived data.
resultsPrevalent AMR mechanisms detected include blaCTX-M-15 (76.8%) and blaNDM-1 (37.5%). An epidemic IncFII(Yp) plasmid carrying blaNDM-1 was also detected in 46 isolates from 6 sentinel sites and 14 different sequence types (STs). This plasmid was also identified as the main vehicle of carbapenem resistance in 2 previously unrecognized local outbreaks of ST348 and ST283 at 2 different sentinel sites. A third local outbreak of ST397 was also identified but without the IncFII(Yp) plasmid. Isolates in each outbreak site showed identical STs and K- and O-loci, and similar resistance profiles and AMR genes. All outbreak isolates were collected from blood of children aged < 1 year.
conclusionWGS provided a better understanding of the epidemiology of multidrug resistant Klebsiella in the Philippines, which was not possible with only phenotypic and epidemiologic data. The identification of 3 previously unrecognized Klebsiella outbreaks highlights the utility of WGS in outbreak detection, as well as its importance in public health and in implementing infection control programs.
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