Dataset Information

Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales.

ABSTRACT: Carbapenemase-producing Enterobacterales (CPE) infection control practices are based on the paradigm that detected carriers in the hospital transmit to other patients who stay in the same ward. The role of plasmid-mediated transmission at population level remains largely unknown. In this retrospective cohort study over 4.7 years involving all multi-disciplinary public hospitals in Singapore, we analysed 779 patients who acquired CPE (1215 CPE isolates) detected by clinical or surveillance cultures. 42.0% met putative clonal transmission criteria, 44.8% met putative plasmid-mediated transmission criteria and 13.2% were unlinked. Only putative clonal transmissions associated with direct ward contact decreased in the second half of the study. Both putative clonal and plasmid-mediated transmission associated with indirect (no temporal overlap in patients' admission period) ward and hospital contact did not decrease during the study period. Indirect ward and hospital contact were identified as independent risk factors associated with clonal transmission. In conclusion, undetected CPE reservoirs continue to evade hospital infection prevention measures. New measures are needed to address plasmid-mediated transmission, which accounted for 50% of CPE dissemination.

SUBMITTER: Marimuthu K

PROVIDER: S-EPMC9160272 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales.

Marimuthu Kalisvar K Venkatachalam Indumathi I Koh Vanessa V Harbarth Stephan S Perencevich Eli E Cherng Benjamin Pei Zhi BPZ Fong Raymond Kok Choon RKC Pada Surinder Kaur SK Ooi Say Tat ST Smitasin Nares N Thoon Koh Cheng KC Tambyah Paul Anantharajah PA Hsu Li Yang LY Koh Tse Hsien TH De Partha Pratim PP Tan Thean Yen TY Chan Douglas D Deepak Rama Narayana RN Tee Nancy Wen Sim NWS Kwa Andrea A Cai Yiying Y Teo Yik-Ying YY Thevasagayam Natascha May NM Prakki Sai Rama Sridatta SRS Xu Weizhen W Khong Wei Xin WX Henderson David D Stoesser Nicole N Eyre David W DW Crook Derrick D Ang Michelle M Lin Raymond Tzer Pin RTP Chow Angela A Cook Alex R AR Teo Jeanette J Ng Oon Tek OT

Nature communications 20220601 1

Carbapenemase-producing Enterobacterales (CPE) infection control practices are based on the paradigm that detected carriers in the hospital transmit to other patients who stay in the same ward. The role of plasmid-mediated transmission at population level remains largely unknown. In this retrospective cohort study over 4.7 years involving all multi-disciplinary public hospitals in Singapore, we analysed 779 patients who acquired CPE (1215 CPE isolates) detected by clinical or surveillance cultur ...[more]

PMID: 35650193

Similar Datasets

Project description:Carbapenems are considered last-line beta-lactams for the treatment of infections caused by multidrug-resistant Gram-negative bacteria. However, their activity is compromised by the rising prevalence of carbapenemase-producing Enterobacterales (CPE), which are especially marked in the Indian subcontinent. In Pakistan, previous reports have warned about the possible spread of CPE in the community, but data are still partial. This study was carried out to analyse the prevalence of CPE, the genetic characterisation, and phylogenetic links among the spreading CPE in the community. In this cohort study, we collected 306 rectal swabs from patients visiting Benazir Bhutto hospital, Rawalpindi. CPEs were screened by using ertapenem-supplemented MacConkey agar. Identification was performed by using conventional biochemical tests, and genomes were sequenced using Illumina chemistry. Antibiotic resistance genes, plasmid incompatibility groups, and Escherichia coli phylogroups were determined in silico. Sequence types were determined by using MLST tool. The prevalence of CPE carriage observed was 14.4% (44/306 samples). The most common carbapenemase-encoding gene was bla-NDM-5 (n = 58) followed by blaNDM-1 (n = 7), blaNDM (non-assigned variant, n = 4), blaOXA-181 (n = 3), blaOXA-232 (n = 3) and blaNDM-7 (n = 1). Most of the CPE were E. coli (55/64, 86%), and the genomic analysis revealed a pauciclonal diffusion of E. coli with ST167 (n = 14), 405 (n = 10), 940 (n = 8), 648 (n = 6) and 617 (n = 5). We obtained a second sample from 94 patients during their hospital stay in whom carriage was negative at admission and found that 7 (7.4%) acquired a CPE. Our results indicate that the prevalence of CPE carriage in the Pakistani urban community was high and driven by the dissemination of some E. coli clones, with ST167 being the most frequent. The high CPE carriage in the community poses a serious public health threat and calls for implementation of adequate preventive measures.

Dataset Information

Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales.

Publications

Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets