Projects per year
Abstract
In some neonatal units, the screening of isolates for antimicrobial-resistant organisms is a matter of routine, with theoretical benefits including the prevention or early detection of outbreaks. This study sought to use whole-genome sequencing (WGS) retrospectively to characterize the genomic epidemiology of Gram-negative organisms obtained from a screening programme in a 32-bed unit providing intensive, high-dependency and special care at City Hospital, Birmingham, UK, identifying occult transmission events and clinically important antimicrobial-resistance (AMR) genes. WGS was performed for 155 isolates collected from rectal and umbilical screening swabs over a 2 month period from 44 individual neonates. Genomic epidemiological analysis showed possible transmission events involving Escherichia coli, Enterobacter cloacae, Klebsiella oxytoca and Klebsiella pneumoniae not detected by routine screening, with eight putative clusters involving different individuals identified. Within phylogenetic clusters, the relatedness of organisms - as determined by the abundance of SNPs - varied widely, indicating that a variety of transmission routes may be implicated. While clinically important AMR genes were not present in the putative transmission clusters, our observation of suspected interspecies horizontal transfer of bla CTX-M-15 within individuals highlights the potential for their spread between organisms as well as individuals in this environment, with implications for surveillance. Our data show that WGS may reveal occult Gram-negative transmission events, demonstrating the potential of sequencing-based surveillance systems for nosocomial pathogens. Challenges remain in understanding how to utilize WGS surveillance to maximum effect in real-world settings.
Original language | English |
---|---|
Article number | 000841 |
Number of pages | 11 |
Journal | Microbial Genomics |
Volume | 8 |
Issue number | 6 |
DOIs | |
Publication status | Published - 13 Jun 2022 |
Bibliographical note
Funding Information:V.P. is supported by a NIHR Academic Clinical fellowship. S.J.D. is funded by the BBSRC (grant no. BB/R006261/1 awarded to A.M.). This work received no specific grant funding from any agency. The authors were fully responsible for study design, execution, preparation of the article and decision to publish.
Publisher Copyright:
© 2022 The Authors.
Keywords
- AMR
- Gram-negative
- infection control
- neonatal
- screening
- transmission
ASJC Scopus subject areas
- Genetics
- Molecular Biology
- Epidemiology
- Microbiology
Fingerprint
Dive into the research topics of 'Whole-genome sequencing enhances existing pathogen and antimicrobial-resistance surveillance schemes within a neonatal unit'. Together they form a unique fingerprint.Projects
- 1 Finished
-
The evolutionary emergence of multidrug resistant bacterial pathogens.
Biotechnology & Biological Sciences Research Council
5/03/18 → 4/03/21
Project: Research Councils