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A prolonged multispecies outbreak of IMP-6 carbapenemase-producing Enterobacterales due to horizontal transmission of the IncN plasmid
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A prolonged multispecies outbreak of IMP-6 carbapenemase-producing Enterobacterales due to horizontal transmission of the IncN plasmid
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A prolonged multispecies outbreak of IMP-6 carbapenemase-producing Enterobacterales due to horizontal transmission of the IncN plasmid
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Journal Article
A prolonged multispecies outbreak of IMP-6 carbapenemase-producing Enterobacterales due to horizontal transmission of the IncN plasmid
2020
Overview
A multispecies outbreak of IMP-6 carbapenemase-producing Enterobacterales (IMP-6-CPE) occurred at an acute care hospital in Japan. This study was conducted to understand the mechanisms of IMP-6-CPE transmission by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing and whole-genome sequencing (WGS), and identify risk factors for IMP-6-CPE acquisition in patients who underwent abdominal surgery. Between July 2013 and March 2014, 22 hospitalized patients infected or colonized with IMP-6-CPE (
Escherichia coli
[n = 8],
Klebsiella oxytoca
[n = 5],
Enterobacter cloacae
[n = 5],
Klebsiella pneumoniae
[n = 3] and
Klebsiella aerogenes
[n = 1]) were identified. There were diverse PFGE profiles and sequence types (STs) in most of the species except for
K. oxytoca
. All isolates of
K. oxytoca
belonged to ST29 with similar PFGE profiles, suggesting their clonal transmission. Plasmid analysis by WGS revealed that all 22 isolates but one shared a ca. 50-kb IncN plasmid backbone with
bla
IMP-6
suggesting interspecies gene transmission, and typing of plasmids explained epidemiological links among cases. A case-control study showed pancreatoduodenectomy, changing drains in fluoroscopy room, continuous peritoneal lavage and enteric fistula were associated with IMP-6-CPE acquisition among the patients. Plasmid analysis of isolates in an outbreak of IMP-6-CPE suggested interspecies gene transmission and helped to clarify hidden epidemiological links between cases.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ 45/23
/ 45/29
/ 45/77
/ Aged
/ Bacterial Proteins - genetics
/ Bacterial Proteins - metabolism
/ beta-Lactamases - metabolism
/ E coli
/ Electrophoresis, Gel, Pulsed-Field
/ Enterobacteriaceae - enzymology
/ Enterobacteriaceae - genetics
/ Enterobacteriaceae Infections - microbiology
/ Enterobacteriaceae Infections - transmission
/ Female
/ Fistulae
/ Genomes
/ Humanities and Social Sciences
/ Humans
/ Male
/ Patients
/ Plasmids
/ Pulsed-field gel electrophoresis
/ Science
/ Surgery
