Long-TermPatientColonization.PDFVIP

Downloaded from RESEARCH ARTICLE crossmark Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization on April 23, 2017 - Published by Sean Conlan,a Morgan Park,b Clayton Deming,a Pamela J. Thomas,b Alice C. Young,b Holly Coleman,b Christina Sison,b NISC Comparative Sequencing Program,b Rebecca A. Weingarten,c Anna F. Lau,c John P. Dekker,c Tara N. Palmore,c Karen M. Frank,c Julia A. Segrea National Human Genome Research Institute, Bethesda, Maryland, USAa; National Institutes of Health Intramural Sequencing Center (NISC), Rockville, Maryland, USAb; National Institutes of Health Clinical Center, Bethesda, Maryland, USAc ABSTRACT Carbapenem-resistant Klebsiella pneumoniae strains are formidable hospital pathogens that pose a serious threat to patients around the globe due to a rising incidence in health care facilities, high mortality rates associated with infection, and potential to spread antibiotic resistance to other bacterial species, such as Escherichia coli. Over 6 months in 2011, 17 patients at the National Institutes of Health (NIH) Clinical Center became colonized with a highly virulent, transmissible carbapenem- resistant strain of K. pneumoniae. Our real-time genomic sequencing tracked patient-to-patient routes of transmission and in- formed epidemiologists’ actions to monitor and control this outbreak. Two of these patients remained colonized with carbapenemase-producing organisms for at least 2 to 4 years, providing the opportunity to undertake a focused genomic stud