Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales.
Journal
Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555
Informations de publication
Date de publication:
01 06 2022
01 06 2022
Historique:
received:
14
04
2021
accepted:
09
05
2022
entrez:
1
6
2022
pubmed:
2
6
2022
medline:
7
6
2022
Statut:
epublish
Résumé
Carbapenemase-producing Enterobacterales (CPE) infection control practices are based on the paradigm that detected carriers in the hospital transmit to other patients who stay in the same ward. The role of plasmid-mediated transmission at population level remains largely unknown. In this retrospective cohort study over 4.7 years involving all multi-disciplinary public hospitals in Singapore, we analysed 779 patients who acquired CPE (1215 CPE isolates) detected by clinical or surveillance cultures. 42.0% met putative clonal transmission criteria, 44.8% met putative plasmid-mediated transmission criteria and 13.2% were unlinked. Only putative clonal transmissions associated with direct ward contact decreased in the second half of the study. Both putative clonal and plasmid-mediated transmission associated with indirect (no temporal overlap in patients' admission period) ward and hospital contact did not decrease during the study period. Indirect ward and hospital contact were identified as independent risk factors associated with clonal transmission. In conclusion, undetected CPE reservoirs continue to evade hospital infection prevention measures. New measures are needed to address plasmid-mediated transmission, which accounted for 50% of CPE dissemination.
Identifiants
pubmed: 35650193
doi: 10.1038/s41467-022-30637-5
pii: 10.1038/s41467-022-30637-5
pmc: PMC9160272
doi:
Substances chimiques
Bacterial Proteins
0
beta-Lactamases
EC 3.5.2.6
carbapenemase
EC 3.5.2.6
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3052Investigateurs
Kalisvar Marimuthu
(K)
Indumathi Venkatachalam
(I)
Benjamin Pei Zhi Cherng
(BPZ)
Raymond Kok Choon Fong
(RKC)
Surinder Kaur Pada
(SK)
Say Tat Ooi
(ST)
Nares Smitasin
(N)
Koh Cheng Thoon
(KC)
Li Yang Hsu
(LY)
Tse Hsien Koh
(TH)
Partha Pratim De
(PP)
Thean Yen Tan
(TY)
Douglas Chan
(D)
Rama Narayana Deepak
(RN)
Nancy Wen Sim Tee
(NWS)
Michelle Ang
(M)
Raymond Tzer Pin Lin
(RTP)
Jeanette Teo
(J)
Oon Tek Ng
(OT)
Informations de copyright
© 2022. The Author(s).
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