Nosocomial transmission of NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center associated with patients from Ukraine

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2024年12月23日

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Wouter L. Smit,
Herman F. Wunderink,
Jan A. J. W. Kluytmans,
Wim J. E. Tissing,
E. H. Pieter van Dijkhuizen,
Yvette G. T. Loeffen,
Antoni P. A. Hendrickx,
D. W. Notermans,
A. L. E. van Arkel,
M. A. Leversteijn-van Hall,
W. van den Bijllaardt,
R. van Mansfeld,
K. van Dijk,
B. Zwart,
B. M. W. Diederen,
H. Berkhout,
A. Ott,
K. Waar,
W. Ang,
J. da Silva,
A. L. M. Vlek,
A. G. M. Buiting,
L. G. M. Bode,
A. Jansz,
S. Paltansing,
A. J. van Griethuysen,
J. R. Lo Ten Foe,
M. J. C. A. van Trijp,
M. Wong,
A. E. Muller,
M. P. M. van der Linden,
M. van Rijn,
S. B. Debast,
E. Kolwijck,
N. Al Naiemi,
T. Schulin,
S. Dinant,
S. P. van Mens,
D. C. Melles,
J. W. T. Cohen Stuart,
P. Gruteke,
A. van Dam,
I. Maat,
B. Maraha,
J. C. Sinnige,
E. van der Vorm,
M. P. A. van Meer,
M. de Graaf,
E. de Jong,
S. J. Vainio,
E. Heikens,
M.den Reijer,
J. W. Dorigo-Zetsma,
A. Troelstra,
E. Bathoorn,
J. de Vries,
D. W. van Dam,
E. I. G. B. de Brauwer,
R. Steingrover

摘要

We studied nosocomial transmission of multidrug-resistant bla_NDM-1-containing Klebsiella pneumoniae ST147 in a Dutch pediatric oncology center. Whole-genome multilocus sequence typing revealed two genetic clusters consisting of 2 and 5 K. pneumoniae isolates, both from Ukrainian medical evacuees and Dutch patients. Ukrainian patients were colonized at admission, and two Dutch patients developed bacteremia. Temporal and spatial transmission links were assessed and sampling of sinks revealed environmental contamination of bla_NDM-1-containing K. pneumoniae with genetic relatedness to cluster isolates. Phylogenetic analysis of 163 K. pneumoniae ST147 isolates from the Dutch national surveillance revealed that transmission-related isolates formed a unique phylogenetic branch.

In conclusion, we demonstrate nosocomial transmission of unique bla_NDM-1-containing K. pneumoniae ST147 strains introduced by Ukrainian patients. Sink drains colonized by genetically similar bla_NDM-1-containing strains in rooms designated as spatial links within the cluster were considered the potential source of transmission. Healthcare professionals should be aware of these risks, particularly in settings with susceptible patients exposed to antibiotic pressure.