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Objectives: Carbapenemase-producing Klebsiella pneumoniae pose an increasing risk for healthcare facilities worldwide. A continuous monitoring of ST distribution and its association with resistance and virulence genes is required for early detection of successful K. pneumoniae lineages. In this study, we used WGS to characterize MDR blaOXA-48-positive K. pneumoniae isolated from inpatients at the University Medical Center Göttingen, Germany, between March 2013 and August 2014.Methods: Closed genomes for 16 isolates of carbapenemase-producing K. pneumoniae were generated by single molecule real-time technology using the PacBio RSII platform.Results: Eight of the 16 isolates showed identical XbaI macrorestriction patterns and shared the same MLST, ST147. The eight ST147 isolates differed by only 1-25 SNPs of their core genome, indicating a clonal origin. Most of the eight ST147 isolates carried four plasmids with sizes of 246.8, 96.1, 63.6 and 61.0 kb and a novel linear plasmid prophage, named pKO2, of 54.6 kb. The blaOXA-48 gene was located on a 63.6 kb IncL plasmid and is part of composite transposon Tn1999.2. The ST147 isolates expressed the yersinabactin system as a major virulence factor. The comparative whole-genome analysis revealed several rearrangements of mobile genetic elements and losses of chromosomal and plasmidic regions in the ST147 isolates.Conclusions: Single molecule real-time sequencing allowed monitoring of the genetic and epigenetic microevolution of MDR OXA-48-producing K. pneumoniae and revealed in addition to SNPs, complex rearrangements of genetic elements. [ABSTRACT FROM AUTHOR]

Linked Article: Calabrese et al. Br J Dermatol 2022; 186:925–941. The interleukin‐1 (IL‐1) family are a group of chemicals called cytokines that form part of our immune system. Unfortunately, the body may start to use these cytokines inappropriately (dysregulation), and they may stimulate certain white blood cells (neutrophils) to increase in number causing inflammation without an infectious trigger. In this paper, the authors from Italy and Germany review the role of the different members of the IL‐1 family in inflammatory skin disorders and the progress being made to develop antibody treatments aiming to reverse their effects. Interleukin‐1 antagonists such as anakinra and canakinumab have already proved useful in the treatment of disorders directly related to neutrophil proliferation, but there is evidence that this group of drugs may also be beneficial in commoner disorders such as psoriasis and atopic eczema. Sometimes a drug that blocks a single cytokine molecule may have limited effect. Laboratory studies suggest that agents that block receptors on the cell surface membrane may be more effective at reducing skin inflammation caused by several IL‐1 subsets. One promising target is IL‐1 receptor accessory protein (IL‐1R3). The authors stress the need for drugs that target the harmful effects of the IL‐1 family at several levels. Linked Article: Calabrese et al. Br J Dermatol 2022; 186:925–941. [ABSTRACT FROM AUTHOR]