Department of Medicine, University of Cambridge, Box 157, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK.
Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
Microb Genom. 2023 Mar;9(3). doi: 10.1099/mgen.0.000924.
The spread of carbapenemase-producing (CPE) is of major public health concern. The transmission dynamics of CPE in hospitals, particularly at the national level, are not well understood. Here, we describe a retrospective nationwide genomic surveillance study of CPE in Ireland between 2012 and 2017. We sequenced 746 national surveillance CPE samples obtained between 2012 and 2017. After clustering the sequences, we used thresholds based on pairwise SNPs, and reported within-host diversity along with epidemiological data to infer recent putative transmissions. All clusters in circulating clones, derived from high-resolution phylogenies, of a species (, , , , and ) were individually examined for evidence of transmission. Antimicrobial resistance trends over time were also assessed. We identified 352 putative transmission events in six species including widespread and frequent transmissions in three species. We detected putative outbreaks in 4/6 species with three hospitals experiencing prolonged outbreaks. The gene was the main cause of carbapenem resistance in Ireland in almost all species. An expansion in the number of sequence types carrying was an additional cause of the increasing prevalence of carbapenemase-producing and .
产碳青霉烯酶 （CPE） 的传播引起了主要的公共卫生关注。医院中 CPE 的传播动力学，特别是在国家层面上，尚未得到很好的理解。在这里，我们描述了 2012 年至 2017 年间在爱尔兰进行的全国范围内针对 CPE 的回顾性基因组监测研究。我们对 2012 年至 2017 年间获得的 746 个全国监测 CPE 样本进行了测序。在对序列进行聚类后，我们使用基于成对 SNPs 的阈值，并报告了宿主内多样性以及流行病学数据，以推断最近的假定传播。从种（、、、、和）的高分辨率系统发育衍生的循环克隆中的所有克隆都单独检查了传播的证据。还评估了随时间推移的抗生素耐药趋势。我们在六种物种中鉴定出 352 种假定的传播事件，其中三种物种中存在广泛而频繁的传播。我们在 6 种物种中的 4 种中检测到假定的暴发，其中 3 家医院经历了长时间的暴发。在几乎所有物种中， 基因是导致爱尔兰碳青霉烯类抗生素耐药的主要原因。携带 的序列类型数量的增加是导致产碳青霉烯酶 和 流行率增加的另一个原因。
