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Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae at a single institution: insights into endemicity from whole-genome sequencing.

Mathers AJ, Stoesser N, Sheppard AE, Pankhurst L, Giess A, Yeh AJ, Didelot X, Turner SD, Sebra R, Kasarskis A, Peto T, Crook D, Sifri CD - Antimicrob. Agents Chemother. (2015)

Bottom Line: Using WGS-based analysis of clinical isolates and plasmid transformants, we demonstrate the unexpected dispersal of blaKPC to many non-ST258 lineages in a hospital through spread of at least two novel blaKPC plasmids.In contrast, ST258 KPC-Kp was imported into the institution on numerous occasions, with other blaKPC plasmid vectors and without sustained transmission.Instead, a newly recognized KPC-Kp strain, ST941, became associated with both novel blaKPC plasmids and spread locally, making it a future candidate for clinical persistence and dissemination.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA Clinical Microbiology, Department of Pathology, University of Virginia Health System, Charlottesville, Virginia, USA ajm5b@virginia.edu.

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Time-scaled representation of genetic relationships between multilocus sequence type ST258 strains. The number of mutational substitutions are represented numerically on the branches, with gray bars at nodes indicating the uncertainty of 95% credibility intervals around the estimates of the time to the most recent common ancestors.
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Figure 4: Time-scaled representation of genetic relationships between multilocus sequence type ST258 strains. The number of mutational substitutions are represented numerically on the branches, with gray bars at nodes indicating the uncertainty of 95% credibility intervals around the estimates of the time to the most recent common ancestors.

Mentions: A ClonalFrame analysis of the seven ST258 isolates demonstrated the TMRCA dating to 1997 (range, 1988 to 2002; Fig. 4). Four of these isolates (CAV1596, CAV1061, CAV1066, and CAV1216) were closely related (≤15 SNVs) and shared proximity to a single outside hospital. The remaining three ST258 KPC-Kp were genetically divergent and imported to UVaMC from three separate outside hospitals in the mid-Atlantic region of the United States. There was no epidemiological evidence of sustained ST258 transmission within UVaMC.


Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae at a single institution: insights into endemicity from whole-genome sequencing.

Mathers AJ, Stoesser N, Sheppard AE, Pankhurst L, Giess A, Yeh AJ, Didelot X, Turner SD, Sebra R, Kasarskis A, Peto T, Crook D, Sifri CD - Antimicrob. Agents Chemother. (2015)

Time-scaled representation of genetic relationships between multilocus sequence type ST258 strains. The number of mutational substitutions are represented numerically on the branches, with gray bars at nodes indicating the uncertainty of 95% credibility intervals around the estimates of the time to the most recent common ancestors.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325807&req=5

Figure 4: Time-scaled representation of genetic relationships between multilocus sequence type ST258 strains. The number of mutational substitutions are represented numerically on the branches, with gray bars at nodes indicating the uncertainty of 95% credibility intervals around the estimates of the time to the most recent common ancestors.
Mentions: A ClonalFrame analysis of the seven ST258 isolates demonstrated the TMRCA dating to 1997 (range, 1988 to 2002; Fig. 4). Four of these isolates (CAV1596, CAV1061, CAV1066, and CAV1216) were closely related (≤15 SNVs) and shared proximity to a single outside hospital. The remaining three ST258 KPC-Kp were genetically divergent and imported to UVaMC from three separate outside hospitals in the mid-Atlantic region of the United States. There was no epidemiological evidence of sustained ST258 transmission within UVaMC.

Bottom Line: Using WGS-based analysis of clinical isolates and plasmid transformants, we demonstrate the unexpected dispersal of blaKPC to many non-ST258 lineages in a hospital through spread of at least two novel blaKPC plasmids.In contrast, ST258 KPC-Kp was imported into the institution on numerous occasions, with other blaKPC plasmid vectors and without sustained transmission.Instead, a newly recognized KPC-Kp strain, ST941, became associated with both novel blaKPC plasmids and spread locally, making it a future candidate for clinical persistence and dissemination.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA Clinical Microbiology, Department of Pathology, University of Virginia Health System, Charlottesville, Virginia, USA ajm5b@virginia.edu.

Show MeSH
Related in: MedlinePlus