Please use this identifier to cite or link to this item: https://doi.org/10.1038/s41467-022-30637-5
Title: Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales
Authors: Marimuthu, Kalisvar 
Venkatachalam, Indumathi 
Koh, Vanessa
Harbarth, Stephan
Perencevich, Eli
Cherng, Benjamin Pei Zhi 
Fong, Raymond Kok Choon
Pada, Surinder Kaur 
Ooi, Say Tat
Smitasin, Nares 
Thoon, Koh Cheng 
Tambyah, Paul Anantharajah 
Hsu, Li Yang 
Koh, Tse Hsien 
De, Partha Pratim
Thean, Yen Tan 
Chan, Douglas
Deepak, Rama Narayana 
Tee, Nancy Wen Sim 
Kwa, Andrea 
Cai, Yiying 
Teo, Yik-Ying 
Thevasagayam, Natascha May 
Prakki, Sai Rama Sridatta 
Xu, Weizhen
Khong, Wei Xin
Henderson, David
Stoesser, Nicole
Eyre, David W
Crook, Derrick
Ang, Michelle
Lin, Raymond Tzer Pin 
Chow, Angela
Cook, Alex R 
Teo, Jeanette
Ng, Oon Tek 
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
RESISTANT KLEBSIELLA-PNEUMONIAE
METALLO-BETA-LACTAMASE
EPIDEMIOLOGY
OUTBREAK
Issue Date: 1-Jun-2022
Publisher: NATURE PORTFOLIO
Citation: Marimuthu, Kalisvar, Venkatachalam, Indumathi, Koh, Vanessa, Harbarth, Stephan, Perencevich, Eli, Cherng, Benjamin Pei Zhi, Fong, Raymond Kok Choon, Pada, Surinder Kaur, Ooi, Say Tat, Smitasin, Nares, Thoon, Koh Cheng, Tambyah, Paul Anantharajah, Hsu, Li Yang, Koh, Tse Hsien, De, Partha Pratim, Thean, Yen Tan, Chan, Douglas, Deepak, Rama Narayana, Tee, Nancy Wen Sim, Kwa, Andrea, Cai, Yiying, Teo, Yik-Ying, Thevasagayam, Natascha May, Prakki, Sai Rama Sridatta, Xu, Weizhen, Khong, Wei Xin, Henderson, David, Stoesser, Nicole, Eyre, David W, Crook, Derrick, Ang, Michelle, Lin, Raymond Tzer Pin, Chow, Angela, Cook, Alex R, Teo, Jeanette, Ng, Oon Tek (2022-06-01). Whole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales. NATURE COMMUNICATIONS 13 (1). ScholarBank@NUS Repository. https://doi.org/10.1038/s41467-022-30637-5
Abstract: Carbapenemase-producing Enterobacterales (CPE) infection control practices are based on the paradigm that detected carriers in the hospital transmit to other patients who stay in the same ward. The role of plasmid-mediated transmission at population level remains largely unknown. In this retrospective cohort study over 4.7 years involving all multi-disciplinary public hospitals in Singapore, we analysed 779 patients who acquired CPE (1215 CPE isolates) detected by clinical or surveillance cultures. 42.0% met putative clonal transmission criteria, 44.8% met putative plasmid-mediated transmission criteria and 13.2% were unlinked. Only putative clonal transmissions associated with direct ward contact decreased in the second half of the study. Both putative clonal and plasmid-mediated transmission associated with indirect (no temporal overlap in patients' admission period) ward and hospital contact did not decrease during the study period. Indirect ward and hospital contact were identified as independent risk factors associated with clonal transmission. In conclusion, undetected CPE reservoirs continue to evade hospital infection prevention measures. New measures are needed to address plasmid-mediated transmission, which accounted for 50% of CPE dissemination.
Source Title: NATURE COMMUNICATIONS
URI: https://scholarbank.nus.edu.sg/handle/10635/228417
ISSN: 20411723
DOI: 10.1038/s41467-022-30637-5
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