Nosocomial transmission of NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center associated with patients from Ukraine

Wouter L Smit; Herman F Wunderink; Jan A J W Kluytmans; Wim J E Tissing; E H Pieter van Dijkhuizen; Yvette G T Loeffen; Antoni P A Hendrickx

doi:10.1186/s12879-024-10368-2

Nosocomial transmission of NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center associated with patients from Ukraine

Wouter L Smit^*
, Herman F Wunderink
, Jan A J W Kluytmans
, Wim J E Tissing
, E H Pieter van Dijkhuizen
, Yvette G T Loeffen
, Antoni P A Hendrickx
,

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

We studied nosocomial transmission of multidrug-resistant bla NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center. Whole-genome multilocus sequence typing revealed two genetic clusters consisting of 2 and 5 K. pneumoniae isolates, both from Ukrainian medical evacuees and Dutch patients. Ukrainian patients were colonized at admission, and two Dutch patients developed bacteremia. Temporal and spatial transmission links were assessed and sampling of sinks revealed environmental contamination of bla NDM-1-containing K. pneumoniae with genetic relatedness to cluster isolates. Phylogenetic analysis of 163 K. pneumoniae ST147 isolates from the Dutch national surveillance revealed that transmission-related isolates formed a unique phylogenetic branch.In conclusion, we demonstrate nosocomial transmission of unique bla NDM-1-containing K. pneumoniae ST147 strains introduced by Ukrainian patients. Sink drains colonized by genetically similar bla NDM-1-containing strains in rooms designated as spatial links within the cluster were considered the potential source of transmission. Healthcare professionals should be aware of these risks, particularly in settings with susceptible patients exposed to antibiotic pressure.

Original language	English
Article number	1460
Journal	BMC Infectious Diseases
Volume	24
Issue number	1
DOIs	https://doi.org/10.1186/s12879-024-10368-2
Publication status	Published - 23 Dec 2024

Keywords

Environmental contamination
Medical evacuees
NDM-1-containing Klebsiella pneumoniae
Nosocomial transmission

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10.1186/s12879-024-10368-2Licence: CC BY-NC-ND

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Smit, W. L., Wunderink, H. F., Kluytmans, J. A. J. W., Tissing, W. J. E., van Dijkhuizen, E. H. P., Loeffen, Y. G. T., Hendrickx, A. P. A. (2024). Nosocomial transmission of NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center associated with patients from Ukraine. BMC Infectious Diseases, 24(1), Article 1460. https://doi.org/10.1186/s12879-024-10368-2

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title = "Nosocomial transmission of NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center associated with patients from Ukraine",

abstract = "We studied nosocomial transmission of multidrug-resistant bla NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center. Whole-genome multilocus sequence typing revealed two genetic clusters consisting of 2 and 5 K. pneumoniae isolates, both from Ukrainian medical evacuees and Dutch patients. Ukrainian patients were colonized at admission, and two Dutch patients developed bacteremia. Temporal and spatial transmission links were assessed and sampling of sinks revealed environmental contamination of bla NDM-1-containing K. pneumoniae with genetic relatedness to cluster isolates. Phylogenetic analysis of 163 K. pneumoniae ST147 isolates from the Dutch national surveillance revealed that transmission-related isolates formed a unique phylogenetic branch.In conclusion, we demonstrate nosocomial transmission of unique bla NDM-1-containing K. pneumoniae ST147 strains introduced by Ukrainian patients. Sink drains colonized by genetically similar bla NDM-1-containing strains in rooms designated as spatial links within the cluster were considered the potential source of transmission. Healthcare professionals should be aware of these risks, particularly in settings with susceptible patients exposed to antibiotic pressure. ",

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doi = "10.1186/s12879-024-10368-2",

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AU - Smit, Wouter L

AU - Wunderink, Herman F

AU - Kluytmans, Jan A J W

AU - Tissing, Wim J E

AU - van Dijkhuizen, E H Pieter

AU - Loeffen, Yvette G T

AU - Hendrickx, Antoni P A

PY - 2024/12/23

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N2 - We studied nosocomial transmission of multidrug-resistant bla NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center. Whole-genome multilocus sequence typing revealed two genetic clusters consisting of 2 and 5 K. pneumoniae isolates, both from Ukrainian medical evacuees and Dutch patients. Ukrainian patients were colonized at admission, and two Dutch patients developed bacteremia. Temporal and spatial transmission links were assessed and sampling of sinks revealed environmental contamination of bla NDM-1-containing K. pneumoniae with genetic relatedness to cluster isolates. Phylogenetic analysis of 163 K. pneumoniae ST147 isolates from the Dutch national surveillance revealed that transmission-related isolates formed a unique phylogenetic branch.In conclusion, we demonstrate nosocomial transmission of unique bla NDM-1-containing K. pneumoniae ST147 strains introduced by Ukrainian patients. Sink drains colonized by genetically similar bla NDM-1-containing strains in rooms designated as spatial links within the cluster were considered the potential source of transmission. Healthcare professionals should be aware of these risks, particularly in settings with susceptible patients exposed to antibiotic pressure.

AB - We studied nosocomial transmission of multidrug-resistant bla NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center. Whole-genome multilocus sequence typing revealed two genetic clusters consisting of 2 and 5 K. pneumoniae isolates, both from Ukrainian medical evacuees and Dutch patients. Ukrainian patients were colonized at admission, and two Dutch patients developed bacteremia. Temporal and spatial transmission links were assessed and sampling of sinks revealed environmental contamination of bla NDM-1-containing K. pneumoniae with genetic relatedness to cluster isolates. Phylogenetic analysis of 163 K. pneumoniae ST147 isolates from the Dutch national surveillance revealed that transmission-related isolates formed a unique phylogenetic branch.In conclusion, we demonstrate nosocomial transmission of unique bla NDM-1-containing K. pneumoniae ST147 strains introduced by Ukrainian patients. Sink drains colonized by genetically similar bla NDM-1-containing strains in rooms designated as spatial links within the cluster were considered the potential source of transmission. Healthcare professionals should be aware of these risks, particularly in settings with susceptible patients exposed to antibiotic pressure.

KW - Environmental contamination

KW - Medical evacuees

KW - NDM-1-containing Klebsiella pneumoniae

KW - Nosocomial transmission

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DO - 10.1186/s12879-024-10368-2

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JO - BMC Infectious Diseases

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Nosocomial transmission of NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center associated with patients from Ukraine

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Correction to: Nosocomial transmission of NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center associated with patients from Ukraine (BMC Infectious Diseases, (2024), 24, 1, (1460), 10.1186/s12879-024-10368-2)

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