Abstract
The worldwide spread of Klebsiella pneumoniae producing extended-spectrum β-lactamase (ESBL-Kp) is a significant threat. Specifically, various pandemic clones of ESBL-Kp are involved in hospital outbreaks and caused serious infections. In that context, we assessed the phenotypic and molecular features of a collection of ESBL-Kp isolates in a French university hospital and evaluated the occurrence of potential cross-transmissions. Over a 2-year period (2017-2018), 204 non-duplicate isolates of ESBL-Kp were isolated from clinical (n = 118, 57.8%) or screening (n = 86, 42.2%) sample cultures. These isolates were predominantly resistant to cotrimoxazole (88.8%) and ofloxacin (82.8%) but remained susceptible to imipenem (99.3%) and amikacin (93.8%). CTX-M-15 was the most frequent ESBL identified (83.6%). Multilocus sequence typing and pulse-field gel electrophoresis analysis showed an important genetic variability with 41 sequence types (ST) and 50 pulsotypes identified, and the over representation of the international epidemic clones ST307 and ST405. An epidemiological link attesting probable cross-transmission has been identified for 16 patients clustered in 4 groups during the study period. In conclusion, we showed here the dissemination of pandemic clones of ESBL-Kp in our hospital on a background of clonal diversity.
Highlights
Over the four past decades, the worldwide spread of extended-spectrum β-lactamases Enterobacterales has become a significant threat [1,2,3]
ESBL-Kp isolates came from rectal swab or feces (n = 59; 40.4%), urines (n = 54; 37.0%), blood (n = 9; 6.2%) and other samples (n = 24; 16.4%)
We have identified two major clonal groups: (i) ST405 with the majority of isolates, (35 out of 36) that clustered in the PT28, (ii) ST307 with the majority of isolates (26 out of 29) that clustered in the PT26
Summary
Over the four past decades, the worldwide spread of extended-spectrum β-lactamases Enterobacterales has become a significant threat [1,2,3]. The recent emergence of carbapenem-resistant Enterobacterales has further restricted antimicrobial treatment options and has amplified the threat to public health [4] Carbapenem-resistant and ESBL-producing Enterobacterales are in the WHO priority pathogens list for research and development of new antibiotics [5]. ESBL K. pneumoniae spread in a hospital
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