Dataset Information
High clonal diversity of ESBL-producing Klebsiella pneumoniae isolates from clinical samples in a non-outbreak situation. A cohort study.
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ABSTRACT: Background
Klebsiella pneumoniae has been responsible for a large number of clonal hospital outbreaks. However, some epidemiological changes have been observed since the emergence of CTX-M enzymes in K. pneumoniae.Aim
To analyse the transmission dynamics of Extended Spectrum ?-Lactamase-producing Klebsiella pneumoniae (ESBL-Kp) in an acute care hospital.Methods
In 2015 a prospective cohort study was conducted. All new consecutive adult patients with ESBL-Kp isolates in all clinical samples were included. Patients with a previous known infection/colonization by ESBL-Kp and patients in high risk areas (e.g., intensive care units) were excluded. Cross-transmission was defined as the carriage of a clonally-related ESBL-Kp between newly diagnosed patients who shared the same ward for ?48?h with another case, within a maximum time window of 4 weeks. ESBL-production was confirmed using the double-disk diffusion method and PCR. Clonal relationships were investigated by rep-PCR and multilocus sequence typing (MLST).Results
Sixty ESBL-Kp isolates from 60 patients were included and analysed. Infections and colonizations were classified as hospital-acquired (52%), healthcare-related (40%) or community-acquired (8%).High genetic diversity was detected. When epidemiological clinical data were combined with the rep-PCR, the patterns identified did not show any cases of cross-transmission. ESBL-Kp were detected in 12.5% of environmental samples. No clonal relationship could be established between environmental reservoirs and patients. The genetic mechanism detected in all strains was associated with bla CTX-M genes, and 97% were CTX-M-15.Conclusions
The dynamics of ESBL-K. pneumoniae isolated in our setting could not be explained by clonal transmission from an index patient. A polyclonal spread of ESBL-Kp was identified.
SUBMITTER: Xercavins M
PROVIDER: S-EPMC6942317 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
Publications
High clonal diversity of ESBL-producing <i>Klebsiella pneumoniae</i> isolates from clinical samples in a non-outbreak situation. A cohort study.
Antimicrobial resistance and infection control 20200103 1
<h4>Background</h4><i>Klebsiella pneumoniae</i> has been responsible for a large number of clonal hospital outbreaks. However, some epidemiological changes have been observed since the emergence of CTX-M enzymes in <i>K. pneumoniae</i>.<h4>Aim</h4>To analyse the transmission dynamics of Extended Spectrum β-Lactamase-producing <i>Klebsiella pneumoniae</i> (ESBL-Kp) in an acute care hospital.<h4>Methods</h4>In 2015 a prospective cohort study was conducted. All new consecutive adult patients with E ...[more]
