Cross-border spread of blaNDM-1- and blaOXA-48-positive Klebsiella pneumoniae: a European collaborative analysis of whole genome sequencing and epidemiological data, 2014 to 2019

Abstract

An alert regarding an outbreak of carbapenem-resistant <i>Klebsiella pneumoniae</i> carrying <i>bla</i> _NDM-1 and <i>bla</i> _OXA-48 carbapenemase-encoding genes was sent by Germany to European Union (EU)/European Economic Area (EEA) countries in October 2019. Since only limited whole genome sequencing (WGS) data on <i>bla</i> _NDM-1- and <i>bla</i> _OXA-48-positive <i>K. pneumoniae</i> were available in the public domain, national public health reference or equivalent expert laboratories from EU/EEA countries were invited to share WGS data from their national collections with the European Centre for Disease Prevention and Control (ECDC) to investigate the international dissemination of this epidemic strain. The analysis identified a Finnish case with an isolate closely related to the German outbreak strain and with an epidemiological link to St. Petersburg, Russia. In addition, several other clusters of genetically related <i>bla</i> _NDM-1- and <i>bla</i> _OXA-48-positive <i>K. pneumoniae</i> unrelated to the German outbreak strain but affecting numerous EU/EEA countries were identified. The aim of this follow-up investigation was to characterise these clusters based on the integrated analysis of the WGS dataset on <i>bla</i> _NDM-1 - and <i>bla</i> _OXA-48-positive <i>K. pneumoniae</i> submitted from 13 EU/EEA countries and additional epidemiological data.