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Epidemic of carbapenem-resistant Klebsiella pneumoniae in Europe is driven by nosocomial spread

2019-11Journal article Restricted access
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dc.contributor.authorDavid, Sophia
dc.contributor.authorReuter, Sandra
dc.contributor.authorHarris, Simon R.
dc.contributor.authorGlasner, Corinna
dc.contributor.authorFeltwell, Theresa
dc.contributor.authorArgimon, Silvia
dc.contributor.authorAbudahab, Khalil
dc.contributor.authorGoater, Richard
dc.contributor.authorGiani, Tommaso
dc.contributor.authorErrico, Giulia
dc.contributor.authorAspbury, Marianne
dc.contributor.authorSjunnebo, Sara
dc.contributor.authorEuSCAPE Working Group
dc.contributor.authorESGEM Study Group
dc.contributor.authorFeil, Edward J.
dc.contributor.authorRossolini, Gian Maria
dc.contributor.authorAanensen, David M.
dc.contributor.authorGrundmann, Hajo
dc.date.accessioned2020-04-23T16:09:33Z
dc.date.available2020-04-23T16:09:33Z
dc.date.issued2019-11
dc.descriptionEuSCAPE Working Group: Portugal - Manuela Caniça, Vera Manageiropt_PT
dc.description.abstractPublic health interventions to control the current epidemic of carbapenem-resistant Klebsiella pneumoniae rely on a comprehensive understanding of its emergence and spread over a wide range of geographical scales. We analysed the genome sequences and epidemiological data of >1,700 K. pneumoniae samples isolated from patients in 244 hospitals in 32 countries during the European Survey of Carbapenemase-Producing Enterobacteriaceae. We demonstrate that carbapenemase acquisition is the main cause of carbapenem resistance and that it occurred across diverse phylogenetic backgrounds. However, 477 of 682 (69.9%) carbapenemase-positive isolates are concentrated in four clonal lineages, sequence types 11, 15, 101, 258/512 and their derivatives. Combined analysis of the genetic and geographic distances between isolates with different β-lactam resistance determinants suggests that the propensity of K. pneumoniae to spread in hospital environments correlates with the degree of resistance and that carbapenemase-positive isolates have the highest transmissibility. Indeed, we found that over half of the hospitals that contributed carbapenemase-positive isolates probably experienced within-hospital transmission, and interhospital spread is far more frequent within, rather than between, countries. Finally, we propose a value of 21 for the number of single nucleotide polymorphisms that optimizes the discrimination of hospital clusters and detail the international spread of the successful epidemic lineage, ST258/512.pt_PT
dc.description.sponsorshipThis work was funded by The Centre for Genomic Pathogen Surveillance, Wellcome Genome Campus, Wellcome (grant nos. 098051 and 099202) and the NIHR Global Health Research Unit on Genomic Surveillance of Antimicrobial Resistance (NIHR 16/136/111). The EuSCAPE project was funded by ECDC through a specific framework contract (ECDC/2012/055) following an open call for tender (OJ/25/04/2012-PROC/2012/036).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationNat Microbiol . 2019 Nov;4(11):1919-1929. doi: 10.1038/s41564-019-0492-8. Epub 2019 Jul 29pt_PT
dc.identifier.doi10.1038/s41564-019-0492-8pt_PT
dc.identifier.issn2058-5276)
dc.identifier.urihttp://hdl.handle.net/10400.18/6495
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherNature Research (part of Springer Nature)pt_PT
dc.relation.publisherversionhttps://www.nature.com/articles/s41564-019-0492-8pt_PT
dc.subjectBacterial Proteinspt_PT
dc.subjectCarbapenem-Resistant Enterobacteriaceaept_PT
dc.subjectCross Infectionpt_PT
dc.subjectEnterobacteriaceae Infectionspt_PT
dc.subjectEpidemicspt_PT
dc.subjectEuropept_PT
dc.subjectHumanspt_PT
dc.subjectMolecular Epidemiologypt_PT
dc.subjectPhylogenypt_PT
dc.subjectPolymorphism, Single Nucleotidept_PT
dc.subjectPropensity Scorept_PT
dc.subjectSequence Analysis, DNApt_PT
dc.titleEpidemic of carbapenem-resistant Klebsiella pneumoniae in Europe is driven by nosocomial spreadpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardURIinfo:eu-repo/grantAgreement/WT/Molecules, Genes and Cells/098051
oaire.awardURIinfo:eu-repo/grantAgreement/WT/Populations and Public Health/099202
oaire.citation.endPage1929pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage1919pt_PT
oaire.citation.titleNature microbiologypt_PT
oaire.citation.volume4pt_PT
oaire.fundingStreamMolecules, Genes and Cells
oaire.fundingStreamPopulations and Public Health
project.funder.identifierhttp://doi.org/10.13039/100010269
project.funder.identifierhttp://doi.org/10.13039/100010269
project.funder.nameWellcome Trust
project.funder.nameWellcome Trust
rcaap.embargofctDe acordo com política editorial da revista.pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT
relation.isProjectOfPublicationda567985-e1de-4bd1-89c7-81cb648fd1ca
relation.isProjectOfPublication104de830-8e1e-4f30-ac6b-06a53df1a9bc
relation.isProjectOfPublication.latestForDiscovery104de830-8e1e-4f30-ac6b-06a53df1a9bc

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