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

Berglund, Bjorn and Hoang, Ngoc Thi Bich and Lundberg, Ludwig and Le, Ngai Kien and Tarnberg, Maria and Nilsson, Maud and Bornefall, Elin and Khu, Dung Thi Khanh and Welander, Jenny and Le, Hai Thanh and Olson, Linus and Dien, Tran Minh and Nilsson, Lennart E. and Larsson, Mattias and Hanberger, Hakan (2021). Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit. Antimicrobial resistance and infection control. 10 :1 , 162
[Research article]

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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.

Authors/Creators:Berglund, Bjorn and Hoang, Ngoc Thi Bich and Lundberg, Ludwig and Le, Ngai Kien and Tarnberg, Maria and Nilsson, Maud and Bornefall, Elin and Khu, Dung Thi Khanh and Welander, Jenny and Le, Hai Thanh and Olson, Linus and Dien, Tran Minh and Nilsson, Lennart E. and Larsson, Mattias and Hanberger, Hakan
Title:Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
Series Name/Journal:Antimicrobial resistance and infection control
Year of publishing :2021
Volume:10
Number:1
Article number:162
Number of Pages:13
Publisher:BMC
ISSN:2047-2994
Language:English
Publication Type:Research article
Article category:Scientific peer reviewed
Version:Published version
Copyright:Creative Commons: Attribution 4.0
Full Text Status:Public
Subjects:(A) Swedish standard research categories 2011 > 3 Medical and Health Sciences > 302 Clinical Medicine > Infectious Medicine
Keywords:Klebsiella pneumoniae, Carbapenem resistance, Carbapenemase, Hospital-acquired infection, Colonisation, Vietnam, Next-generation sequencing
URN:NBN:urn:nbn:se:slu:epsilon-p-114530
Permanent URL:
http://urn.kb.se/resolve?urn=urn:nbn:se:slu:epsilon-p-114530
Additional ID:
Type of IDID
DOI10.1186/s13756-021-01033-3
Web of Science (WoS)000720713000001
ID Code:26931
Faculty:NJ - Fakulteten för naturresurser och jordbruksvetenskap
Department:(NL, NJ) > Department of Molecular Sciences
Deposited By: SLUpub Connector
Deposited On:08 Feb 2022 13:25
Metadata Last Modified:16 May 2022 20:33

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