Emergence and persistent spread of carbapenemase-producing Klebsiella pneumoniae high-risk clones in Greek hospitals, 2013 to 2022

BACKGROUND: Preliminary unpublished results of the survey of carbapenem- and/or colistin-resistant Enterobacterales (CCRE survey) showed the expansion of carbapenemase-producing Klebsiella pneumoniae (CPKP) sequence type (ST) 39 in 12 of 15 participating Greek hospitals in 2019. AIM: We conducted a...

Descripción completa

Detalles Bibliográficos
Autores principales: Tryfinopoulou, Kyriaki, Linkevicius, Marius, Pappa, Olga, Alm, Erik, Karadimas, Kleon, Svartström, Olov, Polemis, Michalis, Mellou, Kassiani, Maragkos, Antonis, Brolund, Alma, Fröding, Inga, David, Sophia, Vatopoulos, Alkiviadis, Palm, Daniel, Monnet, Dominique L, Zaoutis, Theoklis, Kohlenberg, Anke, Perivolioti, Efstathia, Andrikogiannopoulos, Petros, Argyropoulou, Athina, Pournaras, Spyros, Vourli, Sofia, Georgiou, Panagiota Christina, Stamoulos, Konstantinos, Christodoulatos, Gerasimos-Socrates, Ntarouis, Iosif, Varveraki, Sofia, Konsolakis, Christos, Panteli, Kalliopi, Zarkotou, Olympia, Rekleiti, Nektaria, Kousouli, Elisavet, Papadogianni, Marina, Zervaki, Kalina, Gavrilidi, Tatiana, Panopoulou, Maria, Lemonakis, Nikolaos, Grapsa, Anastasia, Karampatakis, Theodoros, Kandilioti, Eleni, Gkiti, Tania, Karapavlidou, Paraskevi, Sideris, Christos, Dafa, Evangelia, Gartzonika, Konstantina, Kittas, Christos, Karavasili, Nikoletta, Xytsas, Stelios, Tsilipounidaki, Katerina, Petinaki, Efthymia, Pasxali, Aggeliki, Sorovou, Glykeria, Krikoni, Efrosini, Bartzavali, Christina, Kolonitsiou, Fevronia, Paliogianni, Fotini, Kaminioti, Christina, Mparka, Christina, Petropoulou, Dimitra, Giannopoulou, Panagiota, Charalampaki, Nikoletta, Kappou, Penelope
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2023
Materias:
Surveillance
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668257/
https://www.ncbi.nlm.nih.gov/pubmed/37997662
http://dx.doi.org/10.2807/1560-7917.ES.2023.28.47.2300571
Descripción
Sumario:BACKGROUND: Preliminary unpublished results of the survey of carbapenem- and/or colistin-resistant Enterobacterales (CCRE survey) showed the expansion of carbapenemase-producing Klebsiella pneumoniae (CPKP) sequence type (ST) 39 in 12 of 15 participating Greek hospitals in 2019. AIM: We conducted a rapid survey to determine the extent of spread of CPKP high-risk clones in Greek hospitals in 2022 and compare the distribution of circulating CPKP clones in these hospitals since 2013. METHODS: We analysed whole genome sequences and epidemiological data of 310 K. pneumoniae isolates that were carbapenem-resistant or ‘susceptible, increased exposure’ from Greek hospitals that participated in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE, 2013–2014), in the CCRE survey (2019) and in a national follow-up survey (2022) including, for the latter, an estimation of transmission events. RESULTS: Five K. pneumoniae STs including ST258/512 (n = 101 isolates), ST11 (n = 93), ST39 (n = 56), ST147 (n = 21) and ST323 (n = 13) accounted for more than 90% of CPKP isolates in the dataset. While ST11, ST147 and ST258/512 have been detected in participating hospitals since 2013 and 2014, KPC-2-producing ST39 and ST323 emerged in 2019 and 2022, respectively. Based on the defined genetic relatedness cut-off, 44 within-hospital transmission events were identified in the 2022 survey dataset, with 12 of 15 participating hospitals having at least one within-hospital transmission event. CONCLUSION: The recent emergence and rapid spread of new high-risk K. pneumoniae clones in the Greek healthcare system related to within-hospital transmission is of concern and highlights the need for molecular surveillance and enhanced infection prevention and control measures.

Ejemplares similares