Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Int J Antimicrob Agents. 2020 May;55(5):105931. doi: 10.1016/j.ijantimicag.2020.105931. Epub 2020 Mar 2.
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.
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.
The most common detected carbapenemase gene was bla, followed by bla 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.
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.
本研究旨在鉴定可能与丹麦住院患者感染相关的克隆相关碳青霉烯酶产生肺炎克雷伯菌复合体成员，并确定可能的流行病学联系。
从 2014 年 1 月至 2018 年 6 月，从 102 名患者中收集了 103 株属于肺炎克雷伯菌复合体的分离株。从全基因组测序（WGS）数据中提取了编码碳青霉烯酶的基因和多位点序列分型（MLST）数据。进行了核心基因组 MLST（cgMLST）聚类分析。利用丹麦国家患者登记处（DNPR）的数据和报告的旅行史，调查了疑似暴发的可能的流行病学联系。
最常见的检测到的碳青霉烯酶基因是 bla，其次是 bla。103 株肺炎克雷伯菌复合体分离株属于 47 种序列型（ST），cgMLST 将分离株分为 80 种不同的复合体型。cgMLST 确定了 13 个包含 2-4 个分离株的簇。对于 13 个簇中的 5 个，至少可以在一些患者之间检测到直接联系（患者在同一天住在同一病房）。在两个簇中，患者同时居住在同一医院，但不在同一病房。在一个簇中，患者之间检测到可能的联系（同一病房内 1-13 天）。对于通过 cgMLST 检测到的五个簇，使用 DNPR 数据无法检测到其流行病学联系。
在这项研究中，cgMLST 结合患者住院数据和旅行信息被发现是一种可靠和详细的方法，可以检测产碳青霉烯酶肺炎克雷伯菌复合体成员的可能克隆传播。
