Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae: Risk Factors and Economic Burden Among Patients with Bloodstream Infections
Jiakang Chen,
Kasim Allel,
Chuyue Zhuo
et al.
Abstract:Introduction
Although Extended-spectrum β-lactamase-producing
Escherichia coli
and
Klebsiella pneumoniae
(ESBL-EK) significantly contribute to bloodstream infections, their economic repercussions remain largely unquantified.
Data Source and Methods
We performed a retrospective analysis of inpatients diagnosed with
Escherichia coli
or
Klebsiella pneumoniae
bacterem… Show more
“…Antimicrobial-resistant strains of Klebsiella pneumoniae (K. pneumoniae) encoding extendedspectrum β-lactamase (ESBL) genes are emerging globally and are associated with increased hospital stays, poor patient outcomes and rising healthcare costs [1]. Notably, third-generation cephalosporin-resistant K. pneumoniae (3GR-Kp) has been associated with increased in-hospital mortality and longer hospital stays [2].…”
Klebsiella pneumoniae (K. pneumoniae) cultures from a hospital-wide outbreak in the UK, which lasted for over 12 months, were sequenced. We sought to sequence and genetically characterise the outbreak strain. Antibiotic Susceptibility Testing (AST) was performed on 65 K. pneumoniae isolates saved from the outbreak. All isolates were sequenced using the Oxford Nanopore Technologies (ONT) MinION flowcell: 10 isolates, including the isolate with the earliest collection date in 2017, were additionally sequenced on the NovaSeq 6000 platform to build high-accuracy nanopore-illumina assemblies. Among the sequenced strains, 60 were typed as ST628. 96.6% (n = 58/60) ST628 strains harboured a large ~247-kb FIB(K) plasmid carrying up to 11 antimicrobial resistance genes, including the extended-spectrum beta-lactamase (ESBL) gene, blaCTX-M-15. Clonality between the outbreak isolates was confirmed using single nucleotide polymorphism (SNP) typing. The outbreak strains were phylogenetically related to clinical ST628 strains identified in 2012, 6 years prior to the outbreak. A rare ESBL K. pneumoniae K2 ST628 strain harbouring a multi-drug resistant (MDR) plasmid encoding the ESBL gene blaCTX-M-15 was detected across multiple independent wards during the protracted nosocomial outbreak. Surveillance of this strain is recommended to prevent future nosocomial outbreaks.
“…Antimicrobial-resistant strains of Klebsiella pneumoniae (K. pneumoniae) encoding extendedspectrum β-lactamase (ESBL) genes are emerging globally and are associated with increased hospital stays, poor patient outcomes and rising healthcare costs [1]. Notably, third-generation cephalosporin-resistant K. pneumoniae (3GR-Kp) has been associated with increased in-hospital mortality and longer hospital stays [2].…”
Klebsiella pneumoniae (K. pneumoniae) cultures from a hospital-wide outbreak in the UK, which lasted for over 12 months, were sequenced. We sought to sequence and genetically characterise the outbreak strain. Antibiotic Susceptibility Testing (AST) was performed on 65 K. pneumoniae isolates saved from the outbreak. All isolates were sequenced using the Oxford Nanopore Technologies (ONT) MinION flowcell: 10 isolates, including the isolate with the earliest collection date in 2017, were additionally sequenced on the NovaSeq 6000 platform to build high-accuracy nanopore-illumina assemblies. Among the sequenced strains, 60 were typed as ST628. 96.6% (n = 58/60) ST628 strains harboured a large ~247-kb FIB(K) plasmid carrying up to 11 antimicrobial resistance genes, including the extended-spectrum beta-lactamase (ESBL) gene, blaCTX-M-15. Clonality between the outbreak isolates was confirmed using single nucleotide polymorphism (SNP) typing. The outbreak strains were phylogenetically related to clinical ST628 strains identified in 2012, 6 years prior to the outbreak. A rare ESBL K. pneumoniae K2 ST628 strain harbouring a multi-drug resistant (MDR) plasmid encoding the ESBL gene blaCTX-M-15 was detected across multiple independent wards during the protracted nosocomial outbreak. Surveillance of this strain is recommended to prevent future nosocomial outbreaks.
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