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2019-12-17Zeitschriftenartikel DOI: 10.25646/6558
IS26-Mediated Transfer of blaNDM–1 as the Main Route of Resistance Transmission During a Polyclonal, Multispecies Outbreak in a German Hospital
dc.contributor.authorWeber, Robert E.
dc.contributor.authorPietsch, Michael
dc.contributor.authorFrühauf, Andre
dc.contributor.authorPfeifer, Yvonne
dc.contributor.authorMartin, Maria
dc.contributor.authorLuft, Dirk
dc.contributor.authorGatermann, Sören
dc.contributor.authorPfennigwerth, Niels
dc.contributor.authorKaase, Martin
dc.contributor.authorWerner, Guido
dc.contributor.authorFuchs, Stephan
dc.date.accessioned2020-03-18T09:29:31Z
dc.date.available2020-03-18T09:29:31Z
dc.date.issued2019-12-17none
dc.identifier.other10.3389/fmicb.2019.02817
dc.identifier.urihttp://edoc.rki.de/176904/6526
dc.description.abstractOne of the most demanding challenges in infection control is the worldwide dissemination of multidrug-resistant (MDR) bacteria in clinical settings. Especially the increasing prevalence of carbapenemase producing Gram-negative pathogens poses an urgent threat to public health, as these enzymes confer resistance to almost all β-lactam antibiotics including carbapenems. In this study, we report a prolonged nosocomial outbreak of various NDM-1-producing Enterobacterales species due to clonal spread and cross-species exchange of plasmids and possibly transposons. Between July 2015 and September 2017, a total of 51 carbapenemase-positive isolates were collected from 38 patients and three environmental sources in a single German hospital. Combining molecular typing methods and whole genome sequencing, the metallo-β-lactamase gene blaNDM–1 was found to be present in 35 isolates of which seven additionally carried the carbapenemase gene blaKPC–2. Core genome MLST (cgMLST) revealed different clusters of closely related isolates of Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Morganella morganii or Enterobacter cloacae indicating clonal spread. The detailed reconstruction of the plasmid sequences revealed that in all outbreak-associated isolates blaNDM–1 was located on similar composite transposons, which were also very similar to Tn125 previously described for Acinetobacter baumannii. In contrast to Tn125, these structures were flanked by IS26 elements, which could facilitate horizontal gene transfer. Moreover, the identical plasmid was found to be shared by E. coli and M. morganii isolates. Our results highlight the importance of detailed genome-based analyses for complex nosocomial outbreaks, allowing the identification of causal genetic determinants and providing insights into potential mechanisms involved in the dissemination of antibiotic resistances between different bacterial species.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.subjectantibiotic resistanceeng
dc.subjectcarbapenemaseeng
dc.subjecthorizontal gene transfereng
dc.subjectwhole genome sequencingeng
dc.subjectNDM-1eng
dc.subjectKPC-2eng
dc.subjectIS26eng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleIS26-Mediated Transfer of blaNDM–1 as the Main Route of Resistance Transmission During a Polyclonal, Multispecies Outbreak in a German Hospitalnone
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:0257-176904/6526-3
dc.identifier.doihttp://dx.doi.org/10.25646/6558
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.2019.02817/fullnone
local.edoc.container-publisher-nameFrontiers Medianone
local.edoc.container-volume10none
local.edoc.container-issue2817none
local.edoc.container-year2019none
local.edoc.container-firstpage1none
local.edoc.container-lastpage14none
local.edoc.rki-departmentInfektionskrankheitennone
dc.description.versionPeer Reviewednone

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