Tracking a Hospital Outbreak of Carbapenem-Resistant Klebsiella pneumoniae with Whole-Genome Sequencing

Nosocomial Infection

Tracking a Hospital Outbreak of Carbapenem-Resistant Klebsiella pneumoniae with Whole-Genome Sequencing

1. Evan S. Snitkin¹,
2. Adrian M. Zelazny²,
3. Pamela J. Thomas¹,
4. Frida Stock²,
5. NISC Comparative Sequencing Program³,
6. David K. Henderson²,
7. Tara N. Palmore²,* and
8. Julia A. Segre¹,*

+ Author Affiliations

1. ¹National Human Genome Research Institute, Bethesda, MD 20892, USA.
2. ²National Institutes of Health Clinical Center, Bethesda, MD 20892, USA.
3. ³National Institutes of Health Intramural Sequencing Center (NISC), Bethesda, MD 20892, USA.

1. ↵*To whom correspondence should be addressed. E-mail: tpalmore@mail.nih.gov (T.N.P.); jsegre@nhgri.nih.gov (J.A.S.)

AbstractBack to Top

The Gram-negative bacteria Klebsiella pneumoniae is a major cause of nosocomial infections, primarily among immunocompromised patients. The emergence of strains resistant to carbapenems has left few treatment options, making infection containment critical. In 2011, the U.S. National Institutes of Health Clinical Center experienced an outbreak of carbapenem-resistant K. pneumoniae that affected 18 patients, 11 of whom died. Whole-genome sequencing was performed on K. pneumoniae isolates to gain insight into why the outbreak progressed despite early implementation of infection control procedures. Integrated genomic and epidemiological analysis traced the outbreak to three independent transmissions from a single patient who was discharged 3 weeks before the next case became clinically apparent. Additional genomic comparisons provided evidence for unexpected transmission routes, with subsequent mining of epidemiological data pointing to possible explanations for these transmissions. Our analysis demonstrates that integration of genomic and epidemiological data can yield actionable insights and facilitate the control of nosocomial transmission.

• Copyright © 2012, American Association for the Advancement of Science

Citation: E. S. Snitkin, A. M. Zelazny, P. J. Thomas, F. Stock, N. C. Program, D. K. Henderson, T. N. Palmore, J. A. Segre, Tracking a Hospital Outbreak of Carbapenem-Resistant Klebsiella pneumoniae with Whole-Genome Sequencing. Sci. Transl. Med. 4, 148ra116 (2012).

Read the Full Text