TY - JOUR
TI - Epidemic of carbapenem-resistant Klebsiella pneumoniae in Europe is
driven by nosocomial spread
AU - David, Sophia
AU - Reuter, Sandra
AU - Harris, Simon R.
AU - Glasner,
AU - Corinna
AU - Feltwell, Theresa
AU - Argimon, Silvia
AU - Abudahab, Khalil
AU - and Goater, Richard
AU - Giani, Tommaso
AU - Errico, Giulia
AU - Aspbury,
AU - Marianne
AU - Sjunnebo, Sara
AU - Feil, Edward J.
AU - Rossolini, Gian
AU - Maria
AU - Aanensen, David M.
AU - Grundmann, Hajo
AU - Koraqi, Andi and
AU - Lacej, Denada
AU - Apfalter, Petra
AU - Hartl, Rainer
AU - Glupczynski,
AU - Youri
AU - Huang, Te-Din
AU - Strateva, Tanya
AU - Marteva-Proevska, Yuliya
AU - and Tambic Andrasevic, Arjana
AU - Butic, Iva
AU - Pieridou-Bagatzouni,
AU - Despo
AU - Maikanti-Charalampous, Panagiota
AU - Hrabak, Jaroslav and
AU - Zemlickova, Helena
AU - Hammerum, Anette
AU - Jakobsen, Lotte
AU - Ivanova,
AU - Marina
AU - Pavelkovich, Anastasia
AU - Jalava, Jari
AU - Osterblad, Monica
AU - and Dortet, Laurent
AU - Vaux, Sophie
AU - Kaase, Martin
AU - Gatermann,
AU - Soeren G.
AU - Vatopoulos, Alkiviadis
AU - Tryfinopoulou, Kyriaki and
AU - Toth, Akos
AU - Janvari, Laura
AU - Boo, Teck Wee
AU - McGrath, Elaine and
AU - Carmeli, Yehuda
AU - Adler, Amos
AU - Pantosti, Annalisa
AU - Monaco,
AU - Monica
AU - Raka, Lul
AU - Kurti, Arsim
AU - Balode, Arta
AU - Saule, Mara
AU - and Miciuleviciene, Jolanta
AU - Mierauskaite, Aiste
AU - Perrin-Weniger,
AU - Monique
AU - Reichert, Paul
AU - Nestorova, Nina
AU - Debattista, Sonia and
AU - Mijovic, Gordana
AU - Lopicic, Milena
AU - Samuelsen, Orjan
AU - Haldorsen,
AU - Bjorg
AU - Zabicka, Dorota
AU - Literacka, Elzbieta
AU - Canica, Manuela
AU - and Manageiro, Vera
AU - Kaftandzieva, Ana
AU - Trajkovska-Dokic, Elena
AU - and Damian, Maria
AU - Lixandru, Brandusa
AU - Jelesic, Zora
AU - Trudic,
AU - Anika
AU - Niks, Milan
AU - Schreterova, Eva
AU - Pirs, Mateja
AU - Cerar,
AU - Tjasa
AU - Oteo, Jesus
AU - Aracil, Belen
AU - Giske, Christian and
AU - Sjostrom, Karin
AU - Gur, Deniz
AU - Cakar, Asli
AU - Woodford, Neil and
AU - Hopkins, Katie
AU - Wiuff, Camilla
AU - Brown, Derek J.
AU - EuSCAPE
AU - Working Grp
AU - ESGEM Study Grp
JO - Nature Microbiology
PY - 2019
VL - 4
TODO - 11
SP - 1919-1929
PB - Lithuanian Nature Research Centre
SN - 2058-5276
TODO - 10.1038/s41564-019-0492-8
TODO - null
TODO - Public health interventions to control the current epidemic of
carbapenem-resistant Klebsiella pneumoniae rely on a comprehensive
understanding of its emergence and spread over a wide range of
geographical scales. We analysed the genome sequences and
epidemiological data of >1,700 K. pneumoniae samples isolated from
patients in 244 hospitals in 32 countries during the European Survey of
Carbapenemase-Producing Enterobacteriaceae. We demonstrate that
carbapenemase acquisition is the main cause of carbapenem resistance and
that it occurred across diverse phylogenetic backgrounds. However, 477
of 682 (69.9%) carbapenemase-positive isolates are concentrated in four
clonal lineages, sequence types 11,15,101, 258/512 and their
derivatives. Combined analysis of the genetic and geographic distances
between isolates with different beta-lactam resistance determinants
suggests that the propensity of K. pneumoniae to spread in hospital
environments correlates with the degree of resistance and that
carbapenemase-positive isolates have the highest transmissibility.
Indeed, we found that over half of the hospitals that contributed
carbapenemase-positive isolates probably experienced within-hospital
transmission, and interhospital spread is far more frequent within,
rather than between, countries. Finally, we propose a value of 21 for
the number of single nucleotide polymorphisms that optimizes the
discrimination of hospital clusters and detail the international spread
of the successful epidemic lineage, ST258/512.
ER -