Evolution and dissemination of the Klebsiella pneumoniae clonal group 258 throughout Israeli post-acute care hospitals, 2008-13
| Autor: | Samira Masarwa, Amos Adler, Michal Gordon, Ziv Lifshitz, Efrat Khabra, Mitchell J. Schwaber, Debbie Ben-David, Orit Zion, Yehuda Carmeli |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Genotype Klebsiella pneumoniae 030106 microbiology Biology Microbiology law.invention Post acute care Evolution Molecular 03 medical and health sciences law Humans Pharmacology (medical) Israel Clade Polymerase chain reaction Bacterial Capsules Local spread Retrospective Studies Pharmacology Cross Infection Molecular Epidemiology Phylogenetic tree Sequence Analysis DNA biology.organism_classification Hospitals Klebsiella Infections Infectious Diseases Multigene Family Multilocus sequence typing Genome Bacterial Subacute Care Multilocus Sequence Typing |
| Zdroj: | The Journal of antimicrobial chemotherapy. 72(8) |
| ISSN: | 1460-2091 |
| Popis: | Objectives The KPC-producing Klebsiella pneumoniae (KPC-KP) clonal group (CG) 258 has disseminated throughout Israeli post-acute care hospitals (PACHs). The objectives of the study were (i) to describe the evolution and (ii) to understand the dissemination modes of CG 258 in the PACH system in Israel. Methods KPC-KP surveillance cultures isolates were collected in Israeli PACHs in three national point-prevalence surveys: 2008, 2011 and 2013. CG 258 was identified by pilv-l PCR. WGS was performed for CG 258 isolates from 9 of 14 PACHs and data extracted for core-genome MLST (cgMLST) and for capsule polysaccharide gene cluster analysis. Results The proportional representation of CG 258 among the KPC-KP isolates increased from 72 of 104 isolates (69.2%) in 2008 to 113 of 133 isolates (85%) in 2011 ( P = 0.004 for 2008 versus 2011) and remained high in 2013 [56 of 67 isolates (83.6%)]. All isolates were related to CG 258 clade 2. cgMLST phylogenetic analysis showed relative convergence in the 2008 survey, with increasing diversification in the subsequent surveys. A predominantly institutional dissemination pattern was observed only in centre F from southern Israel. A predominantly regional dissemination pattern was observed in the two PACHs in Jerusalem. The other PACHs were characterized by a combined institutional and generalized pattern, with the majority of isolates clustering within the same PACH and survey. Conclusions CG 258 clade 2 has retained its predominance despite increased diversification. Although interchanging of CG 258 strains occurred between most PACHs, local spread is the leading cause of its dissemination. |
| Databáze: | OpenAIRE |
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