2026-04-13T03:05:36Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4654642026-03-28T08:14:57Zcom_2072_98col_2072_378192

00925njm 22002777a 4500 dc Marí-Almirall, Marta author Ferrando, Núria author Fernández, Mariana José author Cosgaya, Clara author Viñes, Joaquim author Rubio, Elisa author Cuscó, Anna author Muñoz, Laura author Pellice, Martina author Vergara, Andrea author Campo, Irene author Rodríguez-Serna, Laura author Santana, Gemina author del Río, Ana author Francino, Olga author Ciruela, Pilar author Ballester, Frederic author Marco, Francesc author Martínez, José Antonio author Soriano Viladomiu, Alex author Pitart, Cristina author Vila Estapé, Jordi author Roca, Ignasi author 2021 Objectives: The study aimed to characterize the clonal spread of resistant bacteria and dissemination of resistance plasmids among carbapenem-resistant Enterobacterales at a tertiary hospital in Catalonia, Spain. Methods: Isolates were recovered from surveillance rectal swabs and diagnostic samples. Species identification was by matrix-assisted laser desorption ionization-time time of flight mass spectrometry (MALDI-TOF MS). Molecular typing was performed by pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST). Antimicrobial susceptibility was assessed by gradient-diffusion and carriage of bla genes was detected by PCR. Plasmid typing, conjugation assays, S1-PFGE studies and long-read sequencing were used to characterize resistance plasmids. Results: From July 2018 to February 2019, 125 Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacterales were recovered from 101 inpatients from surveillance (74.4%) or clinical samples (25.6%), in a tertiary hospital in Barcelona. Clonality studies identified a major clone of Klebsiella pneumoniae belonging to sequence type ST15 and additional isolates of K. pneumoniae, Escherichia coli and Enterobacter sp. from different STs. All isolates but one carried the bla allelic variant. The bla gene was located in an IncFIIk plasmid of circa 106 Kb in a non-classical Tn 4401 element designated NTE-pMC-2-1. Whole-genome sequencing revealed different rearrangements of the 106 Kb plasmid while the NTE-pMC-2-1 module was highly conserved. Conclusion: We report a hospital outbreak caused by the clonal dissemination of KPC-producing ST15 K. pneumoniae but also the intra- and inter-species transmission of the bla gene associated with plasmid conjugation and/or transposon dissemination. To our knowledge, this is the first report of an outbreak caused by KPC-producing Enterobacterales isolated from human patients in Catalonia and highlights the relevance of surveillance studies in the early detection and control of antibiotic resistant high-risk clones. Klebsiella Outbreak Antibiotic resistance Carbapenemase Epidemiology Plasmid High-risk clone KPC Clonal Spread and Intra- and Inter-Species Plasmid Dissemination Associated With Klebsiella pneumoniae Carbapenemase-Producing Enterobacterales During a Hospital Outbreak in Barcelona, Spain