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Abstract

Background

Two epidemiologically-unrelated clusters of carbapenemase (KPC)-producing were detected among several healthcare facilities (HCF) in Finland by routine surveillance using whole genome sequencing (WGS).

Aim

The objective was to investigate transmission chains to stop further spread of the responsible strain.

Methods

In this observational retrospective study, cases were defined as patients with KPC-3 sequence type (ST)512 strain detected in Finland from August 2013 to May 2018. Environmental specimens were obtained from surfaces, sinks and toilets in affected wards. WGS was performed on cultures using Illumina MiSeq platform and data were analysed using Ridom SeqShere software core genome multilocus sequence typing (cgMLST) scheme. Epidemiological information of the cases was provided by HCFs.

Results

We identified 20 cases in six HCFs: cluster 1 included 18 cases in five HCFs and cluster 2 two cases in one HCF. In cluster 1, a link with a foreign country was unclear, 6/18 cases without overlapping stay had occupied the same room in one of the five HCFs within > 3 years. In cluster 2, the index case was transferred from abroad, both cases occupied the same room 8 months apart. A strain identical to that of the two cases in cgMLST was isolated from the toilet of the room, suggesting a clonal origin.

Conclusions

The clusters were mostly related to case transfer between facilities and likely involved environmental transmission. We show that CPE surveillance using WGS and collaboration between hospitals are crucial to identify clusters and trace transmission chains.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2019-09-19
2024-04-25
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.38.1800522
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Tracing local and regional clusters of carbapenemase-producing Klebsiella pneumoniae ST512 with whole genome sequencing, Finland, 2013 to 2018
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Janko+van+Beek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Beek Janko</a>, <a href="/search?value1=Kati+R%C3%A4is%C3%A4nen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Räisänen Kati</a>, <a href="/search?value1=Markku+Broas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Broas Markku</a>, <a href="/search?value1=Jari+Kauranen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kauranen Jari</a>, <a href="/search?value1=Arja+K%C3%A4hk%C3%B6l%C3%A4&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kähkölä Arja</a>, <a href="/search?value1=Janne+Laine&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Laine Janne</a>, <a href="/search?value1=Eeva+Mustonen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mustonen Eeva</a>, <a href="/search?value1=Tuija+Nurkkala&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nurkkala Tuija</a>, <a href="/search?value1=Teija+Puhto&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Puhto Teija</a>, <a href="/search?value1=Jaana+Sinkkonen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sinkkonen Jaana</a>, <a href="/search?value1=Senja+Torvinen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Torvinen Senja</a>, <a href="/search?value1=Tarja+Vornanen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vornanen Tarja</a>, <a href="/search?value1=Risto+Vuento&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vuento Risto</a>, <a href="/search?value1=Jari+Jalava&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jalava Jari</a>, <a href="/search?value1=Outi+Lyytik%C3%A4inen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lyytikäinen Outi</a></span>. Tracing local and regional clusters of carbapenemase-producing Klebsiella pneumoniae ST512 with whole genome sequencing, Finland, 2013 to 2018. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(38):pii=1800522. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.38.1800522" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.38.1800522</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 24 Sept 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 03 Mar 2019 </span> </p>
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