Tracking the Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in an Emergency Intensive Care Unit by Whole Genome Sequencing

Li Li,1 Renying Wang,2 Dan Qiao,1 Min Zhou,1 Peipei Jin1 1Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People’s Republic of China; 2Department of Emergency, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai,...

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Main Authors: Li L, Wang R, Qiao D, Zhou M, Jin P
Format: Article
Language:English
Published: Dove Medical Press 2022-10-01
Series:Infection and Drug Resistance
Subjects:
Online Access:https://www.dovepress.com/tracking-the-outbreak-of-carbapenem-resistant-klebsiella-pneumoniae-in-peer-reviewed-fulltext-article-IDR
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author Li L
Wang R
Qiao D
Zhou M
Jin P
author_facet Li L
Wang R
Qiao D
Zhou M
Jin P
author_sort Li L
collection DOAJ
description Li Li,1 Renying Wang,2 Dan Qiao,1 Min Zhou,1 Peipei Jin1 1Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People’s Republic of China; 2Department of Emergency, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Peipei Jin, Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, 999 Xiwang Road, Shanghai, 201801, People’s Republic of China, Tel +86-21-67888999, Fax +86-21-64333548, Email jppei924@163.comPurpose: The spread of carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a great threat to human health, especially in the intensive care unit. The aim of this study was to identify the origin and transmission route of a CRKP outbreak in an emergency intensive care unit (EICU), so as to provide prevention and control strategies for CRKP outbreak.Methods: Between Mar and Jun 2018, 10 CRKP isolates from 5 patients in the EICU ward of Shanghai Ruijin hospital north were collected. Modified carbapenem inactivation method (mCIM) and whole-genome sequencing (WGS) were performed on all 10 CRKP isolates. By integrating the genomic and epidemiological data of our isolates and 9 CRKP isolates from an outbreak in another hospital, a putative transmission map was constructed.Results: All 10 outbreak strains were carbapenemase positive in mCIM and belonged to the sequence type 11 (ST11) clone, harbored a set of resistance genes and virulence genes. The phylogenetic tree of CRKP isolates based on two outbreaks revealed that the initial isolate A1 in our EICU ward belonged to one branch of isolates in another hospital, this introductive isolate evolved and caused a subsequent outbreak in our EICU.Conclusion: Integration of genomic and epidemiological data can yield a clear transmission map of CRKP outbreak. Monitoring the rapid evolution of CRKP at the early stage of outbreak, CRKP monitoring after patients are discharged, active surveillance of newly admitted patients, environmental hygiene and efficient antibiotic treatment may be the key to prevent and control of CRKP outbreak.Keywords: carbapenem-resistant Klebsiella pneumoniae, whole-genome sequencing, transmission map
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spelling doaj.art-70b710d5f2994aaba8862e831e223a5f2022-12-22T03:53:41ZengDove Medical PressInfection and Drug Resistance1178-69732022-10-01Volume 156215622479262Tracking the Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in an Emergency Intensive Care Unit by Whole Genome SequencingLi LWang RQiao DZhou MJin PLi Li,1 Renying Wang,2 Dan Qiao,1 Min Zhou,1 Peipei Jin1 1Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People’s Republic of China; 2Department of Emergency, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Peipei Jin, Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, 999 Xiwang Road, Shanghai, 201801, People’s Republic of China, Tel +86-21-67888999, Fax +86-21-64333548, Email jppei924@163.comPurpose: The spread of carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a great threat to human health, especially in the intensive care unit. The aim of this study was to identify the origin and transmission route of a CRKP outbreak in an emergency intensive care unit (EICU), so as to provide prevention and control strategies for CRKP outbreak.Methods: Between Mar and Jun 2018, 10 CRKP isolates from 5 patients in the EICU ward of Shanghai Ruijin hospital north were collected. Modified carbapenem inactivation method (mCIM) and whole-genome sequencing (WGS) were performed on all 10 CRKP isolates. By integrating the genomic and epidemiological data of our isolates and 9 CRKP isolates from an outbreak in another hospital, a putative transmission map was constructed.Results: All 10 outbreak strains were carbapenemase positive in mCIM and belonged to the sequence type 11 (ST11) clone, harbored a set of resistance genes and virulence genes. The phylogenetic tree of CRKP isolates based on two outbreaks revealed that the initial isolate A1 in our EICU ward belonged to one branch of isolates in another hospital, this introductive isolate evolved and caused a subsequent outbreak in our EICU.Conclusion: Integration of genomic and epidemiological data can yield a clear transmission map of CRKP outbreak. Monitoring the rapid evolution of CRKP at the early stage of outbreak, CRKP monitoring after patients are discharged, active surveillance of newly admitted patients, environmental hygiene and efficient antibiotic treatment may be the key to prevent and control of CRKP outbreak.Keywords: carbapenem-resistant Klebsiella pneumoniae, whole-genome sequencing, transmission maphttps://www.dovepress.com/tracking-the-outbreak-of-carbapenem-resistant-klebsiella-pneumoniae-in-peer-reviewed-fulltext-article-IDRcarbapenem-resistant klebsiella pneumoniaewhole-genome sequencingtransmission map
spellingShingle Li L
Wang R
Qiao D
Zhou M
Jin P
Tracking the Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in an Emergency Intensive Care Unit by Whole Genome Sequencing
Infection and Drug Resistance
carbapenem-resistant klebsiella pneumoniae
whole-genome sequencing
transmission map
title Tracking the Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in an Emergency Intensive Care Unit by Whole Genome Sequencing
title_full Tracking the Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in an Emergency Intensive Care Unit by Whole Genome Sequencing
title_fullStr Tracking the Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in an Emergency Intensive Care Unit by Whole Genome Sequencing
title_full_unstemmed Tracking the Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in an Emergency Intensive Care Unit by Whole Genome Sequencing
title_short Tracking the Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in an Emergency Intensive Care Unit by Whole Genome Sequencing
title_sort tracking the outbreak of carbapenem resistant klebsiella pneumoniae in an emergency intensive care unit by whole genome sequencing
topic carbapenem-resistant klebsiella pneumoniae
whole-genome sequencing
transmission map
url https://www.dovepress.com/tracking-the-outbreak-of-carbapenem-resistant-klebsiella-pneumoniae-in-peer-reviewed-fulltext-article-IDR
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