Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit

Abstract Background The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is a growing problem globally, particularly in low- to middle-income countries (LMICs). Previous studies have shown high rates of CRE colonisation among patients at hospitals in LMICs, with increased risk...

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Autores principales:	Björn Berglund, Ngoc Thi Bich Hoang, Ludwig Lundberg, Ngai Kien Le, Maria Tärnberg, Maud Nilsson, Elin Bornefall, Dung Thi Khanh Khu, Jenny Welander, Hai Thanh Le, Linus Olson, Tran Minh Dien, Lennart E. Nilsson, Mattias Larsson, Håkan Hanberger
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Klebsiella pneumoniae Carbapenem resistance Carbapenemase Hospital-acquired infection Colonisation Vietnam Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/194e6243c9af4b5cb8aac6bc4a205ff9
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spelling	oai:doaj.org-article:194e6243c9af4b5cb8aac6bc4a205ff92021-11-21T12:39:57ZClonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit10.1186/s13756-021-01033-32047-2994https://doaj.org/article/194e6243c9af4b5cb8aac6bc4a205ff92021-11-01T00:00:00Zhttps://doi.org/10.1186/s13756-021-01033-3https://doaj.org/toc/2047-2994Abstract Background The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is a growing problem globally, particularly in low- to middle-income countries (LMICs). Previous studies have shown high rates of CRE colonisation among patients at hospitals in LMICs, with increased risk of hospital-acquired infections. Methods We isolated carbapenem-resistant Klebsiella pneumoniae (CRKP) from faecal samples collected in 2017 from patients at admission and discharge at a Vietnamese neonatal intensive care unit (NICU). 126 CRKP were whole-genome sequenced. The phylogenetic relationship between the isolates and between clinical CRKP isolates collected in 2012–2018 at the same hospital were investigated. Results NDM-type carbapenemase-(61%) and KPC-2-encoding genes (41%) were the most common carbapenem resistance genes observed among the admission and discharge isolates. Most isolates (56%) belonged to three distinct clonal clusters of ST15, carrying bla KPC-2, bla NDM-1 and bla NDM-4, respectively. Each cluster also comprised clinical isolates from blood collected at the study hospital. The most dominant ST15 clone was shown to be related to isolates collected from the same hospital as far back as in 2012. Conclusions Highly resistant CRKP were found colonising admission and discharge patients at a Vietnamese NICU, emphasising the importance of continued monitoring. Whole-genome sequencing revealed a population of CRKP consisting mostly of ST15 isolates in three clonally related clusters, each related to blood isolates collected from the same hospital. Furthermore, clinical isolates collected from previous years (dating back to 2012) were shown to likely be clonally descended from ST15 isolates in the largest cluster, suggesting a successful hospital strain which can colonise inpatients.Björn BerglundNgoc Thi Bich HoangLudwig LundbergNgai Kien LeMaria TärnbergMaud NilssonElin BornefallDung Thi Khanh KhuJenny WelanderHai Thanh LeLinus OlsonTran Minh DienLennart E. NilssonMattias LarssonHåkan HanbergerBMCarticleKlebsiella pneumoniaeCarbapenem resistanceCarbapenemaseHospital-acquired infectionColonisationVietnamInfectious and parasitic diseasesRC109-216ENAntimicrobial Resistance and Infection Control, Vol 10, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Klebsiella pneumoniae Carbapenem resistance Carbapenemase Hospital-acquired infection Colonisation Vietnam Infectious and parasitic diseases RC109-216
spellingShingle	Klebsiella pneumoniae Carbapenem resistance Carbapenemase Hospital-acquired infection Colonisation Vietnam Infectious and parasitic diseases RC109-216 Björn Berglund Ngoc Thi Bich Hoang Ludwig Lundberg Ngai Kien Le Maria Tärnberg Maud Nilsson Elin Bornefall Dung Thi Khanh Khu Jenny Welander Hai Thanh Le Linus Olson Tran Minh Dien Lennart E. Nilsson Mattias Larsson Håkan Hanberger Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
description	Abstract Background The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is a growing problem globally, particularly in low- to middle-income countries (LMICs). Previous studies have shown high rates of CRE colonisation among patients at hospitals in LMICs, with increased risk of hospital-acquired infections. Methods We isolated carbapenem-resistant Klebsiella pneumoniae (CRKP) from faecal samples collected in 2017 from patients at admission and discharge at a Vietnamese neonatal intensive care unit (NICU). 126 CRKP were whole-genome sequenced. The phylogenetic relationship between the isolates and between clinical CRKP isolates collected in 2012–2018 at the same hospital were investigated. Results NDM-type carbapenemase-(61%) and KPC-2-encoding genes (41%) were the most common carbapenem resistance genes observed among the admission and discharge isolates. Most isolates (56%) belonged to three distinct clonal clusters of ST15, carrying bla KPC-2, bla NDM-1 and bla NDM-4, respectively. Each cluster also comprised clinical isolates from blood collected at the study hospital. The most dominant ST15 clone was shown to be related to isolates collected from the same hospital as far back as in 2012. Conclusions Highly resistant CRKP were found colonising admission and discharge patients at a Vietnamese NICU, emphasising the importance of continued monitoring. Whole-genome sequencing revealed a population of CRKP consisting mostly of ST15 isolates in three clonally related clusters, each related to blood isolates collected from the same hospital. Furthermore, clinical isolates collected from previous years (dating back to 2012) were shown to likely be clonally descended from ST15 isolates in the largest cluster, suggesting a successful hospital strain which can colonise inpatients.
format	article
author	Björn Berglund Ngoc Thi Bich Hoang Ludwig Lundberg Ngai Kien Le Maria Tärnberg Maud Nilsson Elin Bornefall Dung Thi Khanh Khu Jenny Welander Hai Thanh Le Linus Olson Tran Minh Dien Lennart E. Nilsson Mattias Larsson Håkan Hanberger
author_facet	Björn Berglund Ngoc Thi Bich Hoang Ludwig Lundberg Ngai Kien Le Maria Tärnberg Maud Nilsson Elin Bornefall Dung Thi Khanh Khu Jenny Welander Hai Thanh Le Linus Olson Tran Minh Dien Lennart E. Nilsson Mattias Larsson Håkan Hanberger
author_sort	Björn Berglund
title	Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
title_short	Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
title_full	Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
title_fullStr	Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
title_full_unstemmed	Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
title_sort	clonal spread of carbapenem-resistant klebsiella pneumoniae among patients at admission and discharge at a vietnamese neonatal intensive care unit
publisher	BMC
publishDate	2021
url	https://doaj.org/article/194e6243c9af4b5cb8aac6bc4a205ff9
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Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit

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