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J Glob Antimicrob Resist. 2018 Dec;15:48-54. doi: 10.1016/j.jgar.2018.06.008. Epub 2018 Jun 22.

Population structure of OXA-48-producing Klebsiella pneumoniae ST405 isolates during a hospital outbreak characterised by genomic typing.

Author information

1
Servicio de Microbiología, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046 Madrid, Spain.
2
Unidad de Microbiología Clínica y Enfermedades Infecciosas, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046 Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Spain.
3
Biomol-Informatics, S.L., Campus Universidad Autónoma de Madrid, C/Faraday 7, 28049 Madrid, Spain.
4
Madrid Science Park, Campus Universidad Autónoma de Madrid, C/Faraday 7, 28049 Madrid, Spain.
5
Servicio de Medicina Preventiva, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046 Madrid, Spain.
6
Red Española de Investigación en Patología Infecciosa (REIPI), Spain; Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220 Madrid, Spain.
7
Centro de Biología Molecular 'Severo Ochoa' (CSIC-UAM), Campus Universidad Autónoma de Madrid C/Nicolás Cabrera 1, 28049 Madrid, Spain.
8
Servicio de Microbiología, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046 Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Spain. Electronic address: jesus.mingorance@idipaz.es.

Abstract

OBJECTIVES:

The aim of this study was to investigate the structure of a broad and sustained hospital outbreak of OXA-48-producing Klebsiella pneumoniae (KpO48) belonging to sequence type 405 (ST405).

METHODS:

Whole-genome sequencing and comparison of ten ST405 KpO48 isolates obtained from clinical samples in our hospital was performed. Using stringent criteria, 36 single nucleotide polymorphisms (SNPs) were detected (range 0-21 in pairwise comparisons), and allele-specific PCR was used to call the SNPs among a larger set of isolates.

RESULTS:

Several haplotypes were identified within the population. The haplotypes did not show a spatial structure, but a temporal evolution of sequential haplotype replacements was observed.

CONCLUSIONS:

The dispersed spatial distribution suggests a reservoir formed by a large pool of colonised patients, and the temporal replacement pattern suggests that the sustained outbreak was composed of several small outbreaks that appeared and rapidly dispersed to several units.

KEYWORDS:

Carbapenemase; Genome; Hospital infection; Klebsiella pneumoniae; OXA-48; Typing

PMID:
29940334
DOI:
10.1016/j.jgar.2018.06.008
[Indexed for MEDLINE]

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