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2019-02-19Zeitschriftenartikel DOI: 10.25646/6247
Plasmid-Mediated Transmission of KPC-2 Carbapenemase in Enterobacteriaceae in Critically Ill Patients
dc.contributor.authorSchweizer, Christian
dc.contributor.authorBischoff, Peter
dc.contributor.authorBender, Jennifer
dc.contributor.authorKola, Axel
dc.contributor.authorGastmeier, Petra
dc.contributor.authorHummel, Manfred
dc.contributor.authorKlefisch, Frank-Rainer
dc.contributor.authorSchoenrath, Felix
dc.contributor.authorFrühauf, Andre
dc.contributor.authorPfeifer, Yvonne
dc.date.accessioned2019-09-04T11:34:44Z
dc.date.available2019-09-04T11:34:44Z
dc.date.issued2019-02-19none
dc.identifier.other10.3389/fmicb.2019.00276
dc.identifier.urihttp://edoc.rki.de/176904/6265
dc.description.abstractCarbapenem-resistant Enterobacteriaceae (CRE) cause health care-associated infections worldwide, and they are of severe concern due to limited treatment options. We report an outbreak of KPC-2-producing CRE that was caused by horizontal transmission of a promiscuous plasmid across different genera of bacteria and hospitals in Germany. Eleven isolates (8 Citrobacter freundii, 2 Klebsiella oxytoca, and 1 Escherichia coli) were obtained from seven critically ill patients during the six months of the outbreak in 2016. One patient developed a CRE infection while the other six patients were CRE-colonized. Three patients died in the course of the hospital stay. Six of the seven patients carried the same C. freundii clone; one K. oxytoca clone was found in two patients, and one patient carried E. coli and C. freundii. Molecular analysis confirmed the presence of a conjugative, blaKPC-2-carrying 70 kb-IncN plasmid in C. freundii and E. coli and an 80 kb-IncN plasmid in K. oxytoca. All transconjugants harbored either the 70 or 80 kb plasmid with blaKPC-2, embedded within transposon variant Tn4401g. Whole genome sequencing and downstream bioinformatics analyses of all plasmid sequences showed an almost perfect match when compared to a blaKPC-2-carrying plasmid of a large outbreak in another German hospital two years earlier. Differences in plasmid sizes and open reading frames point to the presence of inserted mobile genetic elements. There are few outbreak reports worldwide on the transmission of blaKPC-2-carrying plasmids across different bacterial genera. Our data suggest a regional and supraregional spread of blaKPC-2-carrying IncN-plasmids harboring the Tn4401g isoform in Germany.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectmultidrug-resistanceeng
dc.subjectCitrobacter freundii ST98eng
dc.subjectKlebsiella oxytoca ST29eng
dc.subjectEscherichia coli ST369eng
dc.subjectIncNeng
dc.subjectWGSeng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titlePlasmid-Mediated Transmission of KPC-2 Carbapenemase in Enterobacteriaceae in Critically Ill Patientsnone
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:0257-176904/6265-3
dc.identifier.doihttp://dx.doi.org/10.25646/6247
dc.type.versionpublishedVersionnone
local.edoc.container-titleFrontiers in Microbiologynone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://www.frontiersin.org/articles/10.3389/fmicb.2019.00276/fullnone
local.edoc.container-publisher-nameFrontiers Medianone
local.edoc.container-volumeFebruary 2019none
local.edoc.container-issue10none
local.edoc.container-reportyear2019none
local.edoc.container-year2019none
local.edoc.container-firstpage1none
local.edoc.container-lastpage8none
local.edoc.rki-departmentInfektionskrankheitennone
dc.description.versionPeer Reviewednone

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