1. Investigation of possible clonal transmission of carbapenemase-producing Klebsiella pneumoniae complex member isolates in Denmark using core genome MLST and National Patient Registry Data
- Author
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Henrik Hasman, Mikala Wang, Karina Lauenborg Møller, Barbara Juliane Holzknecht, Louise Roer, Esad Dzajic, Turid Snekloth Søndergaard, David Fulgsang-Damgaard, Bent Røder, Frank Hansen, Anette M. Hammerum, Anna Emilie Henius, Lillian Marie Søes, Caroline A S Lauridsen, Ulrik Stenz Justesen, Sanne L Blem, Leif P. Andersen, Claus Østergaard, and Lone Jannok Porsbo
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Klebsiella pneumoniae ,Denmark ,030106 microbiology ,Microbial Sensitivity Tests ,NDM ,Genome ,beta-Lactamases ,03 medical and health sciences ,0302 clinical medicine ,Bacterial Proteins ,Epidemiology ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Typing ,OXA-48 ,Genetics ,biology ,Patient registry ,Transmission (medicine) ,Outbreak ,General Medicine ,biology.organism_classification ,Klebsiella Infections ,KPC ,Carbapenem-Resistant Enterobacteriaceae ,Infectious Diseases ,Multilocus sequence typing ,cgMLST ,Genome, Bacterial ,Multilocus Sequence Typing ,Plasmids ,MLST - Abstract
Objectives: The aim of this study was to identify clonally-related carbapenemase-producing Klebsiella pneumoniae complex members that could be involved in outbreaks among hospitalized patients in Denmark, and to identify possible epidemiological links. Methods: From January 2014 to June 2018, 103 isolates belonging to the K. pneumoniae complex were collected from 102 patients. From the whole-genome sequencing (WGS) data, presence of genes encoding carbapenemase and multilocal sequence typing (MLST) data were extracted. Core genome MLST (cgMLST) cluster analysis was performed. Using data from the Danish National Patient Registry (DNPR) and reported travel history, presumptive outbreaks were investigated for possible epidemiological links. Results: The most common detected carbapenemase gene was bla OXA-48, followed by bla NDM-1. The 103 K. pneumoniae complex isolates belonged to 47 sequence types (STs) and cgMLST subdivided the isolates into 80 different complex types. cgMLST identified 13 clusters with 2-4 isolates per cluster. For five of the 13 clusters, a direct link (the patients stayed at the same ward on the same day) could be detected between at least some of the patients. In two clusters, the patients resided simultaneously at the same hospital, but not the same ward. A possible link (same ward within 1-13 days) was detected for the patients in one cluster. For five clusters detected by cgMLST, no epidemiological link could be detected using data from DNPR. Conclusion: In this study, cgMLST combined with patient hospital admission data and travel information was found to be a reliable and detailed approach to detect possible clonal transmission of carbapenemase-producing K. pneumoniae complex members.
- Published
- 2020
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