Fu Qiao1, Li Wei1, Yu Feng2,3, Shasha Ran4, Lan Zheng5, Yujing Zhang6, Qian Xiang7, Yan Liu8, Xueqin Wu9, Xiaofei Duan10, Wensheng Zhang11, Qu Li12, Hua Guo13, Wenzhi Huang1, Shichao Zhu1, Hongxia Wen2,3, Zhiyong Zong1,2,3. 1. Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China. 2. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China. 3. Center for Pathogen Research, West China Hospital, Sichuan University, Chengdu, China. 4. Department of Infection Control, Chengdu Women and Children Hospital, Chengdu, China. 5. Department of Infection Control, Chengdu Second People's Hospital, Chengdu, China. 6. Department of Infection Control, Chengdu First People's Hospital, Chengdu, China. 7. Department of Infection Control, Sichuan Provincial People's Hospital, Chengdu, China. 8. Department of Infection Control, Affiliated Hospital of Chengdu University, Chengdu, China. 9. Department of Infection Control, Affiliated Hospital of Chengdu Medical College, Chengdu, China. 10. Department of Infection Control, Chengdu Public Health Center, Chengdu, China. 11. Department of Infection Control, Sichuan Integrative Medicine Hospital, Chengdu, China. 12. Department of Infection Control, Sichuan Provincial Hospital for Women and Children, Chengdu, China. 13. Department of Infection Control, Chengdu Third People's Hospital, Chengdu, China.
Abstract
BACKGROUND: Handwashing sinks can become contaminated by carbapenem-resistant Klebsiella (CRK), including carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Klebsiella oxytoca (CRKO), but whether they are major sources of CRK infections remains unknown. METHODS: We performed a prospective multicenter study in 16 intensive care units (ICUs) (9 general and 7 neonatal) at 11 hospitals. All sinks at these locations were sampled to screen CRK. All CRK clinical isolates recovered between 2 weeks before and 3 months after sampling in ICUs with CRK-positive sinks or other participating ICUs at the same hospital were collected. Whole-genome sequencing of all isolates was performed. Isolates of the same sequence type (ST) were assigned to clones by calling single-nucleotide polymorphisms. RESULTS: Among 158 sinks sampled, 6 CRKP and 6 CRKO were recovered from 12 sinks in 7 ICUs, corresponding to a 7.6% CRK contamination rate. Twenty-eight clinical isolates were collected, and all were CRKP. The 34 CRKP isolates belonged to 7 STs, including ST789 (n = 14, all had blaNDM-5); ST11 (n = 12, 5 belonged to KL64 and 7 to KL47, all had blaKPC-2); ST709 (n = 4, all had blaNDM-5); and ST16, ST20, ST1027, and ST2407 (n = 1 each). One particular ST789 clone caused an outbreak and contaminated a sink. ST11_KL47 sink isolates were likely the source of a cluster of clinical isolates. Two ST11_KL64 isolates belonged to a common clone but were from 2 hospitals. CONCLUSIONS: Contaminated sinks were not the major source of CRK in our local settings. ST789 blaNDM-5-carrying CRKP might represent an emerging lineage causing neonatal infections.
BACKGROUND: Handwashing sinks can become contaminated by carbapenem-resistant Klebsiella (CRK), including carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Klebsiella oxytoca (CRKO), but whether they are major sources of CRK infections remains unknown. METHODS: We performed a prospective multicenter study in 16 intensive care units (ICUs) (9 general and 7 neonatal) at 11 hospitals. All sinks at these locations were sampled to screen CRK. All CRK clinical isolates recovered between 2 weeks before and 3 months after sampling in ICUs with CRK-positive sinks or other participating ICUs at the same hospital were collected. Whole-genome sequencing of all isolates was performed. Isolates of the same sequence type (ST) were assigned to clones by calling single-nucleotide polymorphisms. RESULTS: Among 158 sinks sampled, 6 CRKP and 6 CRKO were recovered from 12 sinks in 7 ICUs, corresponding to a 7.6% CRK contamination rate. Twenty-eight clinical isolates were collected, and all were CRKP. The 34 CRKP isolates belonged to 7 STs, including ST789 (n = 14, all had blaNDM-5); ST11 (n = 12, 5 belonged to KL64 and 7 to KL47, all had blaKPC-2); ST709 (n = 4, all had blaNDM-5); and ST16, ST20, ST1027, and ST2407 (n = 1 each). One particular ST789 clone caused an outbreak and contaminated a sink. ST11_KL47 sink isolates were likely the source of a cluster of clinical isolates. Two ST11_KL64 isolates belonged to a common clone but were from 2 hospitals. CONCLUSIONS: Contaminated sinks were not the major source of CRK in our local settings. ST789 blaNDM-5-carrying CRKP might represent an emerging lineage causing neonatal infections.
Authors: Jens T Van Praet; Ann-Sofie Coene; Kris Van De Moortele; Patrick Descheemaeker; Marijke Reynders Journal: Infection Date: 2020-09-10 Impact factor: 7.455