Genomic analysis of the initial dissemination of carbapenem-resistant Klebsiella pneumoniae clones in a tertiary hospital

• DOI: 10.1099/mgen.0.001032
• Publication Date: 2023-06-05T14:17:13Z
• Authors: Neris Garcia-Gonz...; Begoña Fuster; Nuria Tormo; Carme Salvador; Concepcion Gimeno; Fernando Gonzalez...
• Keywords: 0301 basic medicine; plasmids; 0303 health sciences; carbapenem resistance; Genomics; beta-Lactamases; Klebsiella Infections; Clone Cells; Tertiary Care Centers; Klebsiella pneumoniae; Carbapenem-Resistant Enterobacteriaceae; Carbapenems; surveillance; Humans; Research Articles

Carbapenem-resistant

Klebsiella pneumoniae

is a major cause of hospital-acquired infections and the fastest-growing pathogen in Europe. Carbapenem resistance was detected at the Consorcio Hospital General Universitario de Valencia (CHGUV) in early 2015, and there has been a significant increase in carbapenem-resistant isolates since then. In this study, we collected carbapenem-resistant isolates from this hospital during the period of increase (from 2015 to 2019) and studied how

K. pneumoniae

carbapenem-resistant isolates emerged and spread in the hospital. A total of 225 isolates were subjected to whole-genome sequencing with Illumina NextSeq. We characterized the isolates by identifying lineages and antimicrobial resistance genes and plasmids, especially those related to reduced carbapenem susceptibility. Our findings show that the initial carbapenem resistance emergence and dissemination at the CHGUV occurred during a short period of 1 year. Furthermore, it was complex, involving six different lineages of types ST307, ST11, ST101 and ST437, different resistance-determinant factors, including OXA-48, NDM-1, NDM-23 and DHA-1, and different plasmids.