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 PMID:32234124  

Whole-genome sequencing resolves a polyclonal outbreak by extended-spectrum beta-lactam and carbapenem-resistant Klebsiella pneumoniae in a Portuguese tertiary-care hospital.

João Perdigão | Ana Modesto | A L Pereira | O Neto | V Matos | A Godinho | Jody Phelan | James Charleston | Anton Spadar | Paola Florez de Sessions | Martin Hibberd | Susana Campino | A Costa | F Fernandes | F Ferreira | A B Correia | Luisa Gonçalves | Taane G Clark | Aida Duarte
Microbial genomics | 2019

Klebsiella pneumoniae has emerged as an important nosocomial pathogen, with whole-genome sequencing (WGS) significantly improving our ability to characterize associated outbreaks. Our study sought to perform a genome-wide analysis of multiclonal K. pneumoniae isolates (n=39; 23 patients) producing extended spectrum beta-lactamases and/or carbapenemases sourced between 2011 and 2016 in a Portuguese tertiary-care hospital. All isolates showed resistance to third-generation cephalosporins and six isolates (five patients) were also carbapenem resistant. Genome-wide-based phylogenetic analysis revealed a topology representing ongoing dissemination of three main sequence-type (ST) clades (ST15, ST147 and ST307) and transmission across different wards, compatible with missing links that can take the form of undetected colonized patients. Two carbapenemase-coding genes were detected: blaKPC-3, located on a Tn4401d transposon, and blaGES-5 on a novel class 3 integron. Additionally, four genes coding for ESBLs (blaBEL-1, blaCTX-M-8, blaCTX-M-15 and blaCTX-M-32) were also detected. ESBL horizontal dissemination across five clades is highlighted by the similar genetic environments of blaCTX-M-15 gene upstream of ISEcp1 on a Tn3-like transposon. Overall, this study provides a high-resolution genome-wide perspective on the epidemiology of ESBL and carbapenemase-producing K. pneumoniae in a healthcare setting while contributing for the adoption of appropriate intervention and prevention strategies.

Pubmed ID: 32234124

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SAMtools/BCFtools (tool)

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Easyfig (tool)

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PhyML (tool)

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SeaView (tool)

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Graphical user interface for multiple sequence alignment and molecular phylogeny. SeaView also generates phylogenetic trees.

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iTOL (tool)

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