Dissemination of carbapenemase-producing Enterobacterales in Ireland from 2012 to 2017: a retrospective genomic surveillance study.

Autor: Hadjirin NF; Department of Medicine, University of Cambridge, Box 157, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK.; Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK., van Tonder AJ; Department of Veterinary Medicine, University of Cambridge, Madingley Rd, Cambridge, CB3 0ES, UK., Blane B; Department of Medicine, University of Cambridge, Box 157, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK., Lees JA; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK., Kumar N; Wellcome Trust Sanger Institute Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SA, UK., Delappe N; National CPE Reference Laboratory, University Hospital Galway, Galway, Ireland., Brennan W; National CPE Reference Laboratory, University Hospital Galway, Galway, Ireland., McGrath E; National CPE Reference Laboratory, University Hospital Galway, Galway, Ireland., Parkhill J; Department of Veterinary Medicine, University of Cambridge, Madingley Rd, Cambridge, CB3 0ES, UK., Cormican M; National CPE Reference Laboratory, University Hospital Galway, Galway, Ireland.; Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland., Peacock SJ; Department of Medicine, University of Cambridge, Box 157, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK., Ludden C; Department of Medicine, University of Cambridge, Box 157, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK.; Wellcome Trust Sanger Institute Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SA, UK.; Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
Jazyk: angličtina
Zdroj: Microbial genomics [Microb Genom] 2023 Mar; Vol. 9 (3).
DOI: 10.1099/mgen.0.000924
Abstrakt: The spread of carbapenemase-producing Enterobacterales (CPE) is of major public health concern. The transmission dynamics of CPE in hospitals, particularly at the national level, are not well understood. Here, we describe a retrospective nationwide genomic surveillance study of CPE in Ireland between 2012 and 2017. We sequenced 746 national surveillance CPE samples obtained between 2012 and 2017. After clustering the sequences, we used thresholds based on pairwise SNPs, and reported within-host diversity along with epidemiological data to infer recent putative transmissions. All clusters in circulating clones, derived from high-resolution phylogenies, of a species ( Klebsiella pneumoniae , Escherichia coli , Klebsiella oxytoca , Enterobacter cloacae , Enterobacter hormaechei and Citrobacter freundii ) were individually examined for evidence of transmission. Antimicrobial resistance trends over time were also assessed. We identified 352 putative transmission events in six species including widespread and frequent transmissions in three species. We detected putative outbreaks in 4/6 species with three hospitals experiencing prolonged outbreaks. The bla OXA-48 gene was the main cause of carbapenem resistance in Ireland in almost all species. An expansion in the number of sequence types carrying bla OXA-48 was an additional cause of the increasing prevalence of carbapenemase-producing K. pneumoniae and E. coli .
Databáze: MEDLINE