Abstract
Carbapenem-resistant Klebsiella pneumoniae (CR-KP) in patients admitted to hospitals pose a great challenge to treatment. The genes causing resistance to carbapenems are mostly found in plasmids, mobile genetic elements that can spread easily to other bacterial strains, thus exacerbating the problem. Here, we studied 27 CR-KP isolates collected from different types of samples from 16 patients admitted to the medical ward at Siriraj Hospital in Bangkok, Thailand, using next generation sequencing (NGS) and optical DNA mapping (ODM). The majority of the isolates belonged to sequence type (ST) 16 and are described in detail herein. Using ODM, we identified the plasmid carrying the blaNDM-1 gene in the ST16 isolates and the plasmids were very similar, highlighting the possibility of using ODM of plasmids as a surrogate marker of nosocomial spread of bacteria. We also demonstrated that ODM could identify that the blaCTX-M-15 and blaOXA-232 genes in the ST16 isolates were encoded on separate plasmids from the blaNDM-1 gene and from each other. The other three isolates belonged to ST147 and each of them had distinct plasmids encoding blaNDM-1.
Highlights
Infections involving carbapenem-resistant Klebsiella pneumoniae (CR-KP) have become a serious problem worldwide and nosocomial infections caused by CR-KP have grown into a threatening healthcare issue in Thailand [1,2]
There has been a lot of attention towards antimicrobial resistance (AMR) in recent years and surveillance studies have been conducted from time to time to understand the severity of the issue, there is still a lot of effort needed towards understanding how AMR spreads in the community and within healthcare and hospital settings [10]
AMR genes were detected using the assembled draft genome blasted to ResFinder at the Center for Genomic Epidemiology and the Comprehensive Antimicrobial Resistance Database (CARD)
Summary
Infections involving carbapenem-resistant Klebsiella pneumoniae (CR-KP) have become a serious problem worldwide and nosocomial infections caused by CR-KP have grown into a threatening healthcare issue in Thailand [1,2]. A study by Lim et al conducted in Thailand from 2004 to 2010 showed that KP was the second most common bacterium causing bacteremia and 66% of the KP hospital-acquired bacteremia cases were caused by multidrug-resistant (MDR) isolates. There has been a lot of attention towards AMR in recent years and surveillance studies have been conducted from time to time to understand the severity of the issue, there is still a lot of effort needed towards understanding how AMR spreads in the community and within healthcare and hospital settings [10]
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