Emergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase-producing Klebsiella pneumoniae in London

Carbapenemase-producing Enterobacteriaceae (CPE) are emerging worldwide, limiting therapeutic options. Mutational and plasmid-mediated mechanisms of colistin resistance have both been reported. The emergence and clonal spread of colistin resistance was analysed in 40 epidemiologically-related NDM-1...

Full description

Bibliographic Details
Main Authors: Otter, J, Doumith, M, Davies, F, Mookerjee, S, Dyakova, E, Gilchrist, M, Brannigan, E, Bamford, K, Galletly, T, Donaldson, H, Aanensen, D, Ellington, M, Hill, R, Turton, J, Hopkins, K, Woodford, N, Holmes, A
Format: Journal article
Language:English
Published: Nature Publishing Group 2017
_version_ 1797094719907430400
author Otter, J
Doumith, M
Davies, F
Mookerjee, S
Dyakova, E
Gilchrist, M
Brannigan, E
Bamford, K
Galletly, T
Donaldson, H
Aanensen, D
Ellington, M
Hill, R
Turton, J
Hopkins, K
Woodford, N
Holmes, A
author_facet Otter, J
Doumith, M
Davies, F
Mookerjee, S
Dyakova, E
Gilchrist, M
Brannigan, E
Bamford, K
Galletly, T
Donaldson, H
Aanensen, D
Ellington, M
Hill, R
Turton, J
Hopkins, K
Woodford, N
Holmes, A
author_sort Otter, J
collection OXFORD
description Carbapenemase-producing Enterobacteriaceae (CPE) are emerging worldwide, limiting therapeutic options. Mutational and plasmid-mediated mechanisms of colistin resistance have both been reported. The emergence and clonal spread of colistin resistance was analysed in 40 epidemiologically-related NDM-1 carbapenemase producing Klebsiella pneumoniae isolates identified during an outbreak in a group of London hospitals. Isolates from July 2014 to October 2015 were tested for colistin susceptibility using agar dilution, and characterised by whole genome sequencing (WGS). Colistin resistance was detected in 25/38 (65.8%) cases for which colistin susceptibility was tested. WGS found that three potential mechanisms of colistin resistance had emerged separately, two due to different mutations in mgrB, and one due to a mutation in phoQ, with onward transmission of two distinct colistin-resistant variants, resulting in two sub-clones associated with transmission at separate hospitals. A high rate of colistin resistance (66%) emerged over a 10 month period. WGS demonstrated that mutational colistin resistance emerged three times during the outbreak, with transmission of two colistin-resistant variants.
first_indexed 2024-03-07T04:17:53Z
format Journal article
id oxford-uuid:ca015e5c-b289-40cb-9408-bddf83c03579
institution University of Oxford
language English
last_indexed 2024-03-07T04:17:53Z
publishDate 2017
publisher Nature Publishing Group
record_format dspace
spelling oxford-uuid:ca015e5c-b289-40cb-9408-bddf83c035792022-03-27T07:04:18ZEmergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase-producing Klebsiella pneumoniae in LondonJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ca015e5c-b289-40cb-9408-bddf83c03579EnglishSymplectic Elements at OxfordNature Publishing Group2017Otter, JDoumith, MDavies, FMookerjee, SDyakova, EGilchrist, MBrannigan, EBamford, KGalletly, TDonaldson, HAanensen, DEllington, MHill, RTurton, JHopkins, KWoodford, NHolmes, ACarbapenemase-producing Enterobacteriaceae (CPE) are emerging worldwide, limiting therapeutic options. Mutational and plasmid-mediated mechanisms of colistin resistance have both been reported. The emergence and clonal spread of colistin resistance was analysed in 40 epidemiologically-related NDM-1 carbapenemase producing Klebsiella pneumoniae isolates identified during an outbreak in a group of London hospitals. Isolates from July 2014 to October 2015 were tested for colistin susceptibility using agar dilution, and characterised by whole genome sequencing (WGS). Colistin resistance was detected in 25/38 (65.8%) cases for which colistin susceptibility was tested. WGS found that three potential mechanisms of colistin resistance had emerged separately, two due to different mutations in mgrB, and one due to a mutation in phoQ, with onward transmission of two distinct colistin-resistant variants, resulting in two sub-clones associated with transmission at separate hospitals. A high rate of colistin resistance (66%) emerged over a 10 month period. WGS demonstrated that mutational colistin resistance emerged three times during the outbreak, with transmission of two colistin-resistant variants.
spellingShingle Otter, J
Doumith, M
Davies, F
Mookerjee, S
Dyakova, E
Gilchrist, M
Brannigan, E
Bamford, K
Galletly, T
Donaldson, H
Aanensen, D
Ellington, M
Hill, R
Turton, J
Hopkins, K
Woodford, N
Holmes, A
Emergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase-producing Klebsiella pneumoniae in London
title Emergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase-producing Klebsiella pneumoniae in London
title_full Emergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase-producing Klebsiella pneumoniae in London
title_fullStr Emergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase-producing Klebsiella pneumoniae in London
title_full_unstemmed Emergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase-producing Klebsiella pneumoniae in London
title_short Emergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase-producing Klebsiella pneumoniae in London
title_sort emergence and clonal spread of colistin resistance due to multiple mutational mechanisms in carbapenemase producing klebsiella pneumoniae in london
work_keys_str_mv AT otterj emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT doumithm emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT daviesf emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT mookerjees emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT dyakovae emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT gilchristm emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT brannigane emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT bamfordk emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT galletlyt emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT donaldsonh emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT aanensend emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT ellingtonm emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT hillr emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT turtonj emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT hopkinsk emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT woodfordn emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon
AT holmesa emergenceandclonalspreadofcolistinresistanceduetomultiplemutationalmechanismsincarbapenemaseproducingklebsiellapneumoniaeinlondon