A Long-Term Low-Frequency Hospital Outbreak of KPC-Producing Klebsiella pneumoniae Involving Intergenus Plasmid Diffusion and a Persisting Environmental Reservoir
AuthorTofteland, Ståle; Naseer, Mohammed Umaer; Lislevand, Jan Helge; Sundsfjord, Arnfinn; Samuelsen, Ørjan
Background: To study the molecular characteristics of a long-term, low frequency outbreak of blaKPC-2 in a low prevalence setting involving the hospital environment. Methodology/Principal Findings: KPC-producing bacteria were screened by selective chromogenic agar and Real-Time PCR. The presence of antibiotic resistance genes was ascribed by PCRs and subsequent sequencing, and the KPC-producing isolates were phylogenetically typed using PFGE and multi-locus sequence typing. BlaKPC-2-plasmids were identified and analysed by S1-nuclease-PFGE hybridization and PCR based replicon typing. A ,97 kb IncFII plasmid was seen to carry blaKPC-2 in all of the clinical isolates, in one of the isolates recovered from screened patients (1/136), and in the Klebsiella pneumoniae and Enterobacter asburiae isolates recovered from the environment (sinks) in one intensive care unit. The K. pneumoniae strain ST258 was identified in 6 out of 7 patients. An intergenus spread to E. asburiae and an interspecies spread to two different K. pneumoniae clones (ST27 and ST461) of the blaKPC-2 plasmid was discovered. K. pneumoniae ST258 and genetically related E. asburiae strains were found in isolates of both human and environmental origins. Conclusions/Significance: We document a clonal transmission of the K. pneumoniae ST258 strain, and an intergenus plasmid diffusion of the IncFII plasmid carrying blaKPC-2 in this outbreak. A major reservoir in the patient population could not be unveiled. However, the identification of a persisting environmental reservoir of strains with molecular determinants linked to human isolates, suggests a possible role of the environment in the maintenance of this long-term outbreak.
PublisherPublic Library of Science (PLoS)
CitationPLoS ONE (2013), vol. 8(3): e59015.
MetadataShow full item record
The following license file are associated with this item:
Showing items related by title, author, creator and subject.
Prognostic Impacts of Angiopoietins in NSCLC Tumor Cells and Stroma : VEGF-A Impact Is Strongly Associated with Ang-2 Andersen, Sigve; Dønnem, Tom; Al-Shibli, Khalid Ibrahim; Al-Saad, Samer; Stenvold, Helge; Busund, Lill-Tove; Bremnes, Roy M. (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)Angiopoietins and their receptor Tie-2 are, in concert with VEGF-A, key mediators in angiogenesis. This study evaluates the prognostic impact of all known human angiopoietins (Ang-1, Ang-2 and Ang-4) and their receptor Tie-2, as well as their relation to the prognostic expression of VEGF-A. 335 unselected stage I-IIIA NSCLC-patients were included and tissue samples of respective tumor cells and ...
The Temporomandibular Joint in Juvenile Idiopathic Arthritis, focusing on Quality of Life, Oral Microbiome and Intervention Frid, Paula (Doctoral thesis; Doktorgradsavhandling, 2020-10-02)The temporomandibular joint (TMJ) is commonly involved in juvenile idiopathic arthritis (JIA), and may lead to impaired mouth opening, pain and facial growth disturbances. Asymptomatic TMJ arthritis may be diagnosed late in the disease course, thus management is challenging. The overall objectives of this thesis were to provide new knowledge on quality of life (QoL), the oral microbiome and interventions ...
Humant papillomavirus : en litteraturstudie om HPV, dets relasjon til cancer og tiltak mot videre spredning av virus Gabrielsen, Endre (Master thesis; Mastergradsoppgave, 2012-06-01)I 1983 oppdaget zur Hausen sammenhengen mellom Humant Papillomavirus (HPV) og livmorhalskreft. På denne tiden visste man ikke at det var HPV som var årsaken til at Helaceller kunne leve in vitro. Ny forskning relaterer HPV til en rekke andre cancertyper. En stor andel anal-, oropharyngeal-, penis-, vaginal-, og vulvacancer skyldes HPV. Det er også påvist HPV i tumorvev fra øsofagus, larynx, lunge, ...