A one health study of the genetic relatedness of klebsiella pneumoniae and their mobile elements in the east of England

Catherine Ludden, Danesh Moradigaravand, Dorota Jamrozy, Theodore Gouliouris, Beth Blane, Plamena Naydenova, Juan Hernandez-Garcia, Paul Wood, Nazreen Hadjirin, Milorad Radakovic, Charles Crawley, Nicholas M. Brown, Mark Holmes, Julian Parkhill, Sharon J. Peacock

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Background. Klebsiella pneumoniae is a human, animal, and environmental commensal and a leading cause of nosocomial infections, which are often caused by multiresistant strains. We evaluate putative sources of K. pneumoniae that are carried by and infect hospital patients. Methods. We conducted a 6-month survey on 2 hematology wards at Addenbrooke's Hospital, Cambridge, United Kingdom, in 2015 to isolate K. pneumoniae from stool, blood, and the environment. We conducted cross-sectional surveys of K. pneumoniae from 29 livestock farms, 97 meat products, the hospital sewer, and 20 municipal wastewater treatment plants in the East of England between 2014 and 2015. Isolates were sequenced and their genomes compared. Results. Klebsiella pneumoniae was isolated from stool of 17/149 (11%) patients and 18/922 swabs of their environment, together with 1 bloodstream infection during the study and 4 others over a 24-month period. Each patient carried 1 or more lineages that was unique to them, but 2 broad environmental contamination events and patient-environment transmission were identified. Klebsiella pneumoniae was isolated from cattle, poultry, hospital sewage, and 12/20 wastewater treatment plants. There was low genetic relatedness between isolates from patients/their hospital environment vs isolates from elsewhere. Identical genes encoding cephalosporin resistance were carried by isolates from humans/environment and elsewhere but were carried on different plasmids. Conclusion. We identified no patient-to-patient transmission and no evidence for livestock as a source of K. pneumoniae infecting humans. However, our findings reaffirm the importance of the hospital environment as a source of K. pneumoniae associated with serious human infection.
Original languageEnglish (US)
Pages (from-to)219-226
Number of pages8
JournalClinical Infectious Diseases
Volume70
Issue number2
DOIs
StatePublished - Jan 15 2020
Externally publishedYes

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

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