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Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization

Carbapenem-resistant Klebsiella pneumoniae strains are formidable hospital pathogens that pose a serious threat to patients around the globe due to a rising incidence in health care facilities, high mortality rates associated with infection, and potential to spread antibiotic resistance to other bac...

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Autores principales: Conlan, Sean, Park, Morgan, Deming, Clayton, Thomas, Pamela J., Young, Alice C., Coleman, Holly, Sison, Christina, Weingarten, Rebecca A., Lau, Anna F., Dekker, John P., Palmore, Tara N., Frank, Karen M., Segre, Julia A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937214/
https://www.ncbi.nlm.nih.gov/pubmed/27353756
http://dx.doi.org/10.1128/mBio.00742-16
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author Conlan, Sean
Park, Morgan
Deming, Clayton
Thomas, Pamela J.
Young, Alice C.
Coleman, Holly
Sison, Christina
Weingarten, Rebecca A.
Lau, Anna F.
Dekker, John P.
Palmore, Tara N.
Frank, Karen M.
Segre, Julia A.
author_facet Conlan, Sean
Park, Morgan
Deming, Clayton
Thomas, Pamela J.
Young, Alice C.
Coleman, Holly
Sison, Christina
Weingarten, Rebecca A.
Lau, Anna F.
Dekker, John P.
Palmore, Tara N.
Frank, Karen M.
Segre, Julia A.
author_sort Conlan, Sean
collection PubMed
description Carbapenem-resistant Klebsiella pneumoniae strains are formidable hospital pathogens that pose a serious threat to patients around the globe due to a rising incidence in health care facilities, high mortality rates associated with infection, and potential to spread antibiotic resistance to other bacterial species, such as Escherichia coli. Over 6 months in 2011, 17 patients at the National Institutes of Health (NIH) Clinical Center became colonized with a highly virulent, transmissible carbapenem-resistant strain of K. pneumoniae. Our real-time genomic sequencing tracked patient-to-patient routes of transmission and informed epidemiologists’ actions to monitor and control this outbreak. Two of these patients remained colonized with carbapenemase-producing organisms for at least 2 to 4 years, providing the opportunity to undertake a focused genomic study of long-term colonization with antibiotic-resistant bacteria. Whole-genome sequencing studies shed light on the underlying complex microbial colonization, including mixed or evolving bacterial populations and gain or loss of plasmids. Isolates from NIH patient 15 showed complex plasmid rearrangements, leaving the chromosome and the bla(KPC)-carrying plasmid intact but rearranging the two other plasmids of this outbreak strain. NIH patient 16 has shown continuous colonization with bla(KPC)-positive organisms across multiple time points spanning 2011 to 2015. Genomic studies defined a complex pattern of succession and plasmid transmission across two different K. pneumoniae sequence types and an E. coli isolate. These findings demonstrate the utility of genomic methods for understanding strain succession, genome plasticity, and long-term carriage of antibiotic-resistant organisms.
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spelling pubmed-49372142016-07-12 Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization Conlan, Sean Park, Morgan Deming, Clayton Thomas, Pamela J. Young, Alice C. Coleman, Holly Sison, Christina Weingarten, Rebecca A. Lau, Anna F. Dekker, John P. Palmore, Tara N. Frank, Karen M. Segre, Julia A. mBio Research Article Carbapenem-resistant Klebsiella pneumoniae strains are formidable hospital pathogens that pose a serious threat to patients around the globe due to a rising incidence in health care facilities, high mortality rates associated with infection, and potential to spread antibiotic resistance to other bacterial species, such as Escherichia coli. Over 6 months in 2011, 17 patients at the National Institutes of Health (NIH) Clinical Center became colonized with a highly virulent, transmissible carbapenem-resistant strain of K. pneumoniae. Our real-time genomic sequencing tracked patient-to-patient routes of transmission and informed epidemiologists’ actions to monitor and control this outbreak. Two of these patients remained colonized with carbapenemase-producing organisms for at least 2 to 4 years, providing the opportunity to undertake a focused genomic study of long-term colonization with antibiotic-resistant bacteria. Whole-genome sequencing studies shed light on the underlying complex microbial colonization, including mixed or evolving bacterial populations and gain or loss of plasmids. Isolates from NIH patient 15 showed complex plasmid rearrangements, leaving the chromosome and the bla(KPC)-carrying plasmid intact but rearranging the two other plasmids of this outbreak strain. NIH patient 16 has shown continuous colonization with bla(KPC)-positive organisms across multiple time points spanning 2011 to 2015. Genomic studies defined a complex pattern of succession and plasmid transmission across two different K. pneumoniae sequence types and an E. coli isolate. These findings demonstrate the utility of genomic methods for understanding strain succession, genome plasticity, and long-term carriage of antibiotic-resistant organisms. American Society for Microbiology 2016-06-28 /pmc/articles/PMC4937214/ /pubmed/27353756 http://dx.doi.org/10.1128/mBio.00742-16 Text en Copyright © 2016 Conlan et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (http://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Conlan, Sean
Park, Morgan
Deming, Clayton
Thomas, Pamela J.
Young, Alice C.
Coleman, Holly
Sison, Christina
Weingarten, Rebecca A.
Lau, Anna F.
Dekker, John P.
Palmore, Tara N.
Frank, Karen M.
Segre, Julia A.
Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization
title Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization
title_full Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization
title_fullStr Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization
title_full_unstemmed Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization
title_short Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization
title_sort plasmid dynamics in kpc-positive klebsiella pneumoniae during long-term patient colonization
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937214/
https://www.ncbi.nlm.nih.gov/pubmed/27353756
http://dx.doi.org/10.1128/mBio.00742-16
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