Nosocomial transmission of NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center associated with patients from Ukraine
We studied nosocomial transmission of multidrug-resistant bla<sub>NDM-1</sub>-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<sub>NDM-1</sub>-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<sub>NDM-1</sub>-containing K. pneumoniae ST147 strains introduced by Ukrainian patients. Sink drains colonized by genetically similar bla<sub>NDM-1</sub>-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.
Authors
- Wei Ang (ORCID: https://orcid.org/0000-0003-0849-4749)
- Eva Kolwijck
- S. Dinant
- A. J. van Griethuysen
- E. van der Vorm
- Hanneke Berkhout
- Jerome R. Lo Ten Foe
- M. van Rijn (ORCID: https://orcid.org/0000-0002-0007-2448)
- M. J. C. A. van Trijp
- Erik Bathoorn (ORCID: https://orcid.org/0000-0003-2319-8147)
- Nashwan al Naiemi (ORCID: https://orcid.org/0000-0002-0176-9853)
- S Vainio
- T. Schülin (ORCID: https://orcid.org/0000-0002-0441-1654)
- Daan W. Notermans (ORCID: https://orcid.org/0000-0002-9494-0989)
- Herman F. Wunderink
- L. Bode (ORCID: https://orcid.org/0000-0002-2096-1015)
- A. G. M. Buiting
- Rosa van Mansfeld
- S. Paltansing
- B. Zwart
- M den Reijer
- J. de Vries (ORCID: https://orcid.org/0000-0003-2533-3808)
- A. L. M. Vlek
- Wouter L. Smit (ORCID: https://orcid.org/0000-0001-8826-8957)
- Alje P. van Dam (ORCID: https://orcid.org/0000-0003-3967-550X)
- Anouk E. Muller (ORCID: https://orcid.org/0000-0001-5042-6251)
- Radjin Steingrover
- J. C. Sinnige
- Ianthe Maat
- E. Heikens
- Karin van Dijk (ORCID: https://orcid.org/0000-0002-2054-2857)
- Wouter van den Bijllaardt (ORCID: https://orcid.org/0000-0003-0676-2594)
- Andreas van Arkel (ORCID: https://orcid.org/0000-0003-3391-9200)
- Marcus Ho Yin Wong (ORCID: https://orcid.org/0000-0001-5472-8337)
- Annet Troelstra
- Wim J. E. Tissing (ORCID: https://orcid.org/0000-0001-9101-507X)
- Damian C. Melles∗
- Yvette G. T. Loeffen
- Alewijn Ott
- Antoni P. A. Hendrickx (ORCID: https://orcid.org/0000-0003-4431-9323)
- B. M. W. Diederen
- B. Maraha (ORCID: https://orcid.org/0000-0003-2639-9024)
- E.M.G.J. de Jong (ORCID: https://orcid.org/0000-0003-3872-5704)
- P Gruteke (ORCID: https://orcid.org/0000-0003-1788-5960)
- J. da Silva
- Martin de Graaf (ORCID: https://orcid.org/0000-0001-7948-3292)
- J W Dorigo-Zetsma
- K. Waar
- Jan Kluytmans
- M. A. Hall
- A Jansz
- D. W. van Dam
- J. W. T. Cohen Stuart
- S. P. van Mens
- E. I. G. B. de Brauwer
- Maurits P. A. van Meer
- M. P. M. van der Linden
- S. B. Debast
- E. H. Pieter van Dijkhuizen
Institutions
- Utrecht University (NL)
- University Medical Center Utrecht (NL)
- National Institute for Public Health and the Environment (NL)
- Princess Máxima Center (NL)
- Wilhelmina Children's Hospital (NL)
Publication Details
- Journal
- BMC Infectious Diseases
- Published
- 2024-12-23
- DOI
- https://doi.org/10.1186/s12879-024-10368-2
- Citations
- 2
- Primary Topic
- Antibiotic Resistance in Bacteria
- Type
- article
- Field-Weighted Citation Impact
- 0.34
Funders
- Ministerie van Volksgezondheid, Welzijn en Sport
- Rijksinstituut voor Volksgezondheid en Milieu