Outbreak of NDM-1-Producing Klebsiella pneumoniae in a Dutch Hospital, with Interspecies Transfer of the Resistance Plasmid and Unexpected Occurrence in Unrelated Health Care Centers

Journal of Clinical Microbiology
Thijs BoschLeo M Schouls

Abstract

In the Netherlands, the number of cases of infection with New Delhi metallo-beta-lactamase (NDM)-positive Enterobacteriaceae is low. Here, we report an outbreak of NDM-1-producing Klebsiella pneumoniae infection in a Dutch hospital with interspecies transfer of the resistance plasmid and unexpected occurrence in other unrelated health care centers (HCCs). Next-generation sequencing was performed on 250 carbapenemase-producing Enterobacteriaceae isolates, including 42 NDM-positive isolates obtained from 29 persons at the outbreak site. Most outbreak isolates were K. pneumoniae (n = 26) and Escherichia coli (n = 11), but 5 isolates comprising three other Enterobacteriaceae species were also cultured. The 26 K. pneumoniae isolates had sequence type 873 (ST873), as did 7 unrelated K. pneumoniae isolates originating from five geographically dispersed HCCs. The 33 ST873 isolates that clustered closely together using whole-genome multilocus sequence typing (wgMLST) carried the same plasmids and had limited differences in the resistome. The 11 E. coli outbreak isolates showed great variety in STs, did not cluster using wgMLST, and showed considerable diversity in resistome and plasmid profiles. The blaNDM-1 gene-carrying plasmid presen...Continue Reading

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Citations

Sep 7, 2017·Microbial Drug Resistance : MDR : Mechanisms, Epidemiology, and Disease·Encho SavovAthanasios Tsakris
Jul 24, 2018·Microbial Genomics·Hayley Wilson, M Estée Török
Feb 1, 2019·Clinical Microbiology Reviews·Wenjing WuZhiyong Zong
Sep 9, 2020·Emerging Microbes & Infections·Claudia E CoipanEelco Franz
May 2, 2020·Monash Bioethics Review·Niels NijsinghChristina Åhrén
Sep 3, 2020·EFSA Journal·UNKNOWN European Food Safety Authority, UNKNOWN European Centre for Disease Prevention and Control
Feb 28, 2020·Clinical Microbiology Reviews·Karen Bush, Patricia A Bradford
Oct 10, 2020·Scientific Reports·Antoni P A HendrickxUNKNOWN Dutch CPE surveillance Study Group
May 1, 2021·International Journal of Molecular Sciences·Vanessa AratoFrancesca Micoli
May 18, 2021·Access Microbiology·Arun Gonzales DecanoTim Downing
Dec 25, 2021·Journal of the Pediatric Infectious Diseases Society·Alexander L Greninger, Danielle M Zerr

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