Evolution of Outbreak-Causing Carbapenem-Resistant Klebsiella pneumoniae ST258 at a Tertiary Care Hospital over 8 Years

Author:

Marsh Jane W.1,Mustapha Mustapha M.1,Griffith Marissa P.1,Evans Daniel R.2,Ezeonwuka Chinelo1,Pasculle A. William3,Shutt Kathleen A.1,Sundermann Alexander14,Ayres Ashley M.4,Shields Ryan K.2,Babiker Ahmed2ORCID,Cooper Vaughn S.5ORCID,Van Tyne Daria2,Harrison Lee H.1

Affiliation:

1. Infectious Diseases Epidemiology Research Unit, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, USA

2. Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

3. Division of Microbiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

4. Division of Hospital Epidemiology and Infection Control, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

5. Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

Abstract

The carbapenem class of antibiotics is invaluable for the treatment of selected multidrug-resistant Gram-negative pathogens. The continued transmission of carbapenem-resistant bacteria such as ST258 K. pneumoniae is of serious global public health concern, as treatment options for these infections are limited. This genomic epidemiologic investigation traced the natural history of ST258 K. pneumoniae in a single health care setting over nearly a decade. We found that distinct ST258 subpopulations have caused both device-associated and ward-associated outbreaks, and some of these populations remain endemic within our hospital to the present day. The finding of virulence determinants among emergent ST258 clones supports the idea of convergent evolution of drug-resistant and virulent CRKP strains and highlights the need for continued surveillance, prevention, and control efforts to address emergent and evolving ST258 populations in the health care setting.

Funder

HHS | NIH | National Institute of Allergy and Infectious Diseases

Publisher

American Society for Microbiology

Subject

Virology,Microbiology

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