The DOI matches its Crossref record; 54 of the 54 references it cites were found in a registry or an index.
Epidemic of carbapenem-resistant Klebsiella pneumoniae in Europe is driven by nosocomial spread
Open accessAbstract
Public health interventions to control the current epidemic of carbapenem-resistant Klebsiella pneumoniae rely on a comprehensive understanding of its emergence and spread over a wide range of geographical scales. We analysed the genome sequences and epidemiological data of >1,700 K. pneumoniae samples isolated from patients in 244 hospitals in 32 countries during the European Survey of Carbapenemase-Producing Enterobacteriaceae. We demonstrate that carbapenemase acquisition is the main cause of carbapenem resistance and that it occurred across diverse phylogenetic backgrounds. However, 477 of 682 (69.9%) carbapenemase-positive isolates are concentrated in four clonal lineages, sequence types 11, 15, 101, 258/512 and their derivatives. Combined analysis of the genetic and geographic distances between isolates with different β-lactam resistance determinants suggests that the propensity of K. pneumoniae to spread in hospital environments correlates with the degree of resistance and that carbapenemase-positive isolates have the highest transmissibility. Indeed, we found that over half of the hospitals that contributed carbapenemase-positive isolates probably experienced within-hospital transmission, and interhospital spread is far more frequent within, rather than between, countries. Finally, we propose a value of 21 for the number of single nucleotide polymorphisms that optimizes the discrimination of hospital clusters and detail the international spread of the successful epidemic lineage, ST258/512. Genomic and epidemiological analysis of carbapenem-resistant Klebsiella pneumoniae across Europe finds increased transmissibility of four clonal lineages, especially between hospitals within countries.
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Metadata
- Authors
- David, S., Reuter, S., Harris, S. R., Glasner, C., Feltwell, T., Argimon, S., Abudahab, K., Goater, R., Giani, T., Errico, G., Aspbury, M., Sjunnebo, S., the EuSCAPE Working Group, Koraqi, A., Lacej, D., Apfalter, P., Hartl, R., Glupczynski, Y., Huang, T.-D., Strateva, T., Marteva-Proevska, Y., Andrasevic, A. T., Butic, I., Pieridou-Bagatzouni, D., Maikanti-Charalampous, P., Hrabak, J., Zemlickova, H., Hammerum, A., Jakobsen, L., Ivanova, M., Pavelkovich, A., Jalava, J., Österblad, M., Dortet, L., Vaux, S., Kaase, M., Gatermann, S. G., Vatopoulos, A., Tryfinopoulou, K., Tóth, Á., Jánvári, L., Boo, T. W., McGrath, E., Carmeli, Y., Adler, A., Pantosti, A., Monaco, M., Raka, L., Kurti, A., Balode, A., Saule, M., Miciuleviciene, J., Mierauskaite, A., Perrin-Weniger, M., Reichert, P., Nestorova, N., Debattista, S., Mijovic, G., Lopicic, M., Samuelsen, Ø., Haldorsen, B., Zabicka, D., Literacka, E., Caniça, M., Manageiro, V., Kaftandzieva, A., Trajkovska-Dokic, E., Damian, M., Lixandru, B., Jelesic, Z., Trudic, A., Niks, M., Schreterova, E., Pirs, M., Cerar, T., Oteo, J., Aracil, B., Giske, C., Sjöström, K., Gür, D., Cakar, A., Woodford, N., Hopkins, K., Wiuff, C., Brown, D. J., the ESGEM Study Group, Feil, E. J., Rossolini, G. M., Aanensen, D. M., & Grundmann, H.
- Venue
- Nature Microbiology
- Published
- 2019-07-29
- Volume
- 4
- Issue
- 11
- Pages
- 1919-1929
- ISSN
- 2058-5276 (ISSN-L)
- OpenAlex
- W2965957986
- Cited by
- 773
- References
- 54
- FWCI
- 25.91
- Type
- journal article
- Language
- en
- Open access
- green
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- David, S., Reuter, S., Harris, S. R., Glasner, C., Feltwell, T., Argimon, S., Abudahab, K., Goater, R., Giani, T., Errico, G., Aspbury, M., Sjunnebo, S., the EuSCAPE Working Group, Koraqi, A., Lacej, D., Apfalter, P., Hartl, R., Glupczynski, Y., Huang, T.-D., . . . Grundmann, H. (2019). Epidemic of carbapenem-resistant Klebsiella pneumoniae in Europe is driven by nosocomial spread. Nature Microbiology. https://doi.org/10.1038/s41564-019-0492-8
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