Contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single center
Abstract Background Two of the most important pathogens contributing to the global rise in antimicrobial resistance (AMR) are Klebsiella pneumoniae and Enterobacter cloacae. Despite this, most of our knowledge about the changing patterns of disease caused by these two pathogens is based on studies w...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | Genome Biology |
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| Online Access: | http://link.springer.com/article/10.1186/s13059-019-1785-1 |
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| author | Matthew J. Ellington Eva Heinz Alexander M. Wailan Matthew J. Dorman Marcus de Goffau Amy K. Cain Sonal P. Henson Nicholas Gleadall Christine J. Boinett Gordon Dougan Nicholas M. Brown Neil Woodford Julian Parkhill M. Estée Török Sharon J. Peacock Nicholas R. Thomson |
| author_facet | Matthew J. Ellington Eva Heinz Alexander M. Wailan Matthew J. Dorman Marcus de Goffau Amy K. Cain Sonal P. Henson Nicholas Gleadall Christine J. Boinett Gordon Dougan Nicholas M. Brown Neil Woodford Julian Parkhill M. Estée Török Sharon J. Peacock Nicholas R. Thomson |
| author_sort | Matthew J. Ellington |
| collection | DOAJ |
| description | Abstract Background Two of the most important pathogens contributing to the global rise in antimicrobial resistance (AMR) are Klebsiella pneumoniae and Enterobacter cloacae. Despite this, most of our knowledge about the changing patterns of disease caused by these two pathogens is based on studies with limited timeframes that provide few insights into their population dynamics or the dynamics in AMR elements that they can carry. Results We investigate the population dynamics of two priority AMR pathogens over 7 years between 2007 and 2012 in a major UK hospital, spanning changes made to UK national antimicrobial prescribing policy in 2007. Between 2006 and 2012, K. pneumoniae showed epidemiological cycles of multi-drug-resistant (MDR) lineages being replaced approximately every 2 years. This contrasted E. cloacae where there was no temporally changing pattern, but a continuous presence of the mixed population. Conclusions The differing patterns of clonal replacement and acquisition of mobile elements shows that the flux in the K. pneumoniae population was linked to the introduction of globally recognized MDR clones carrying drug resistance markers on mobile elements. However, E. cloacae carries a chromosomally encoded ampC conferring resistance to front-line treatments and shows that MDR plasmid acquisition in E. cloacae was not indicative of success in the hospital. This led to markedly different dynamics in the AMR populations of these two pathogens and shows that the mechanism of the resistance and its location in the genome or mobile elements is crucial to predict population dynamics of opportunistic pathogens in clinical settings. |
| first_indexed | 2024-12-13T05:42:39Z |
| format | Article |
| id | doaj.art-f036a345f97748a0b9feb81855d82e3f |
| institution | Directory Open Access Journal |
| issn | 1474-760X |
| language | English |
| last_indexed | 2024-12-13T05:42:39Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Genome Biology |
| spelling | doaj.art-f036a345f97748a0b9feb81855d82e3f2022-12-21T23:57:45ZengBMCGenome Biology1474-760X2019-09-0120111610.1186/s13059-019-1785-1Contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single centerMatthew J. Ellington0Eva Heinz1Alexander M. Wailan2Matthew J. Dorman3Marcus de Goffau4Amy K. Cain5Sonal P. Henson6Nicholas Gleadall7Christine J. Boinett8Gordon Dougan9Nicholas M. Brown10Neil Woodford11Julian Parkhill12M. Estée Török13Sharon J. Peacock14Nicholas R. Thomson15Public Health England, National Infection Service, Addenbrooke’s HospitalWellcome Sanger Institute, Wellcome Genome CampusWellcome Sanger Institute, Wellcome Genome CampusWellcome Sanger Institute, Wellcome Genome CampusWellcome Sanger Institute, Wellcome Genome CampusWellcome Sanger Institute, Wellcome Genome CampusKEMRI-Wellcome Trust Research Programme, CGMRCPublic Health England, National Infection Service, Addenbrooke’s HospitalWellcome Sanger Institute, Wellcome Genome CampusWellcome Sanger Institute, Wellcome Genome CampusPublic Health England, National Infection Service, Addenbrooke’s HospitalAntimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health EnglandWellcome Sanger Institute, Wellcome Genome CampusPublic Health England, National Infection Service, Addenbrooke’s HospitalPublic Health England, National Infection Service, Addenbrooke’s HospitalWellcome Sanger Institute, Wellcome Genome CampusAbstract Background Two of the most important pathogens contributing to the global rise in antimicrobial resistance (AMR) are Klebsiella pneumoniae and Enterobacter cloacae. Despite this, most of our knowledge about the changing patterns of disease caused by these two pathogens is based on studies with limited timeframes that provide few insights into their population dynamics or the dynamics in AMR elements that they can carry. Results We investigate the population dynamics of two priority AMR pathogens over 7 years between 2007 and 2012 in a major UK hospital, spanning changes made to UK national antimicrobial prescribing policy in 2007. Between 2006 and 2012, K. pneumoniae showed epidemiological cycles of multi-drug-resistant (MDR) lineages being replaced approximately every 2 years. This contrasted E. cloacae where there was no temporally changing pattern, but a continuous presence of the mixed population. Conclusions The differing patterns of clonal replacement and acquisition of mobile elements shows that the flux in the K. pneumoniae population was linked to the introduction of globally recognized MDR clones carrying drug resistance markers on mobile elements. However, E. cloacae carries a chromosomally encoded ampC conferring resistance to front-line treatments and shows that MDR plasmid acquisition in E. cloacae was not indicative of success in the hospital. This led to markedly different dynamics in the AMR populations of these two pathogens and shows that the mechanism of the resistance and its location in the genome or mobile elements is crucial to predict population dynamics of opportunistic pathogens in clinical settings.http://link.springer.com/article/10.1186/s13059-019-1785-1Resistance mechanismsPopulation dynamicsIntrinsic resistancePlasmid diversity |
| spellingShingle | Matthew J. Ellington Eva Heinz Alexander M. Wailan Matthew J. Dorman Marcus de Goffau Amy K. Cain Sonal P. Henson Nicholas Gleadall Christine J. Boinett Gordon Dougan Nicholas M. Brown Neil Woodford Julian Parkhill M. Estée Török Sharon J. Peacock Nicholas R. Thomson Contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single center Genome Biology Resistance mechanisms Population dynamics Intrinsic resistance Plasmid diversity |
| title | Contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single center |
| title_full | Contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single center |
| title_fullStr | Contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single center |
| title_full_unstemmed | Contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single center |
| title_short | Contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single center |
| title_sort | contrasting patterns of longitudinal population dynamics and antimicrobial resistance mechanisms in two priority bacterial pathogens over 7 years in a single center |
| topic | Resistance mechanisms Population dynamics Intrinsic resistance Plasmid diversity |
| url | http://link.springer.com/article/10.1186/s13059-019-1785-1 |
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