Amos Adler1,2, Ziv Lifshitz3, Michal Gordon4, Debbie Ben-David3, Efrat Khabra3, Samira Masarwa3, Orit Zion5, Mitchell J Schwaber2,3, Yehuda Carmeli2,3. 1. Clinical Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. National Center of Infection Control, Ministry of Health, Tel Aviv, Israel. 4. The National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Be'er-Sheba, Israel. 5. Israel National Center for Personalized Medicine, Weizmann Institute of Science, Rehovot, Israel.
Abstract
Objectives: The KPC-producing Klebsiella pneumoniae (KPC-KP) clonal group (CG) 258 has disseminated throughout Israeli post-acute care hospitals (PACHs). The objectives of the study were (i) to describe the evolution and (ii) to understand the dissemination modes of CG 258 in the PACH system in Israel. Methods: KPC-KP surveillance cultures isolates were collected in Israeli PACHs in three national point-prevalence surveys: 2008, 2011 and 2013. CG 258 was identified by pilv-l PCR. WGS was performed for CG 258 isolates from 9 of 14 PACHs and data extracted for core-genome MLST (cgMLST) and for capsule polysaccharide gene cluster analysis. Results: The proportional representation of CG 258 among the KPC-KP isolates increased from 72 of 104 isolates (69.2%) in 2008 to 113 of 133 isolates (85%) in 2011 ( P = 0.004 for 2008 versus 2011) and remained high in 2013 [56 of 67 isolates (83.6%)]. All isolates were related to CG 258 clade 2. cgMLST phylogenetic analysis showed relative convergence in the 2008 survey, with increasing diversification in the subsequent surveys. A predominantly institutional dissemination pattern was observed only in centre F from southern Israel. A predominantly regional dissemination pattern was observed in the two PACHs in Jerusalem. The other PACHs were characterized by a combined institutional and generalized pattern, with the majority of isolates clustering within the same PACH and survey. Conclusions: CG 258 clade 2 has retained its predominance despite increased diversification. Although interchanging of CG 258 strains occurred between most PACHs, local spread is the leading cause of its dissemination.
Objectives: The KPC-producing Klebsiella pneumoniae (KPC-KP) clonal group (CG) 258 has disseminated throughout Israeli post-acute care hospitals (PACHs). The objectives of the study were (i) to describe the evolution and (ii) to understand the dissemination modes of CG 258 in the PACH system in Israel. Methods: KPC-KP surveillance cultures isolates were collected in Israeli PACHs in three national point-prevalence surveys: 2008, 2011 and 2013. CG 258 was identified by pilv-l PCR. WGS was performed for CG 258 isolates from 9 of 14 PACHs and data extracted for core-genome MLST (cgMLST) and for capsule polysaccharide gene cluster analysis. Results: The proportional representation of CG 258 among the KPC-KP isolates increased from 72 of 104 isolates (69.2%) in 2008 to 113 of 133 isolates (85%) in 2011 ( P = 0.004 for 2008 versus 2011) and remained high in 2013 [56 of 67 isolates (83.6%)]. All isolates were related to CG 258 clade 2. cgMLST phylogenetic analysis showed relative convergence in the 2008 survey, with increasing diversification in the subsequent surveys. A predominantly institutional dissemination pattern was observed only in centre F from southern Israel. A predominantly regional dissemination pattern was observed in the two PACHs in Jerusalem. The other PACHs were characterized by a combined institutional and generalized pattern, with the majority of isolates clustering within the same PACH and survey. Conclusions: CG 258 clade 2 has retained its predominance despite increased diversification. Although interchanging of CG 258 strains occurred between most PACHs, local spread is the leading cause of its dissemination.
Authors: Joshua L C Wong; Sophia David; Julia Sanchez-Garrido; Jia Z Woo; Wen Wen Low; Fabio Morecchiato; Tommaso Giani; Gian Maria Rossolini; Konstantinos Beis; Stephen J Brett; Abigail Clements; David M Aanensen; Silvi Rouskin; Gad Frankel Journal: Proc Natl Acad Sci U S A Date: 2022-09-12 Impact factor: 12.779
Authors: Floriana Gona; Francesco Comandatore; Simone Battaglia; Aurora Piazza; Alberto Trovato; Giovanni Lorenzin; Paola Cichero; Anna Biancardi; Paola Nizzero; Matteo Moro; Daniela Maria Cirillo Journal: Microb Genom Date: 2020-03-09