Abstract
Multidrug-resistant bacteria pose a serious health threat, especially in hospitals. Horizontal gene transfer (HGT) of mobile genetic elements (MGEs) facilitates the spread of antibiotic resistance, virulence, and environmental persistence genes between nosocomial pathogens. We screened the genomes of 2173 bacterial isolates from healthcare-associated infections from a single hospital over 18 months, and identified identical nucleotide regions in bacteria belonging to distinct genera. To further resolve these shared sequences, we performed long-read sequencing on a subset of isolates and generated highly contiguous genomes. We then tracked the appearance of ten different plasmids in all 2173 genomes, and found evidence of plasmid transfer independent from bacterial transmission. Finally, we identified two instances of likely plasmid transfer within individual patients, including one plasmid that likely transferred to a second patient. This work expands our understanding of HGT in healthcare settings, and can inform efforts to limit the spread of drug-resistant pathogens in hospitals.
Highlights
Horizontal gene transfer (HGT) is a driving force behind the multidrug-resistance and heightened virulence of healthcare-associated bacterial infections[1]
Genes conferring antibiotic resistance, heightened virulence, and environmental persistence are often encoded on mobile genetic elements (MGEs), which can be readily shared between bacterial pathogens via HGT2
We identified complete and fragmented MGEs that were identical in nucleotide sequence and occurred in the genomes of bacteria belonging to different genera
Summary
Horizontal gene transfer (HGT) is a driving force behind the multidrug-resistance and heightened virulence of healthcare-associated bacterial infections[1]. Genes conferring antibiotic resistance, heightened virulence, and environmental persistence are often encoded on mobile genetic elements (MGEs), which can be readily shared between bacterial pathogens via HGT2. While rates of HGT are not well quantified in clinical settings, prior studies have shown that. MGEs can mediate and/or exacerbate nosocomial outbreaks[3,4,5,6]. Recent studies have demonstrated that multidrug-resistant healthcare-associated bacteria share MGEs across large phylogenetic distances[7,8,9]. Understanding the dynamics of MGE transfer in clinical settings can uncover important epidemiologic links that are not currently identified by traditional infection control methodologies[1,10,11]
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