Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022–February 2023
Abstract Introduction Despite a scarcity of data, before 2022 Ukraine was already considered a high-prevalence country for carbapenemase-producing Enterobacterales (CPE), and the situation has dramatically worsened during the full-scale war with Russia. The aim of this study was to analyse CPEs isol...
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Adis, Springer Healthcare
2025-01-01
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| Series: | Infectious Diseases and Therapy |
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| Online Access: | https://doi.org/10.1007/s40121-024-01097-9 |
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| author | Marta Biedrzycka Radosław Izdebski Waleria Hryniewicz Marek Gniadkowski Dorota Żabicka |
| author_facet | Marta Biedrzycka Radosław Izdebski Waleria Hryniewicz Marek Gniadkowski Dorota Żabicka |
| author_sort | Marta Biedrzycka |
| collection | DOAJ |
| description | Abstract Introduction Despite a scarcity of data, before 2022 Ukraine was already considered a high-prevalence country for carbapenemase-producing Enterobacterales (CPE), and the situation has dramatically worsened during the full-scale war with Russia. The aim of this study was to analyse CPEs isolated in Poland from victims of war in Ukraine. Methods The study included 65 CPE isolates from March 2022 till February 2023, recovered in 36 Polish medical centres from 57 patients arriving from Ukraine, differing largely by age and reason for hospitalisation. All isolates were sequenced by MiSeq and ten Klebsiella pneumoniae isolates also by MinION. Taxonomy, clonality and resistomes were analysed for all CPEs, whereas phylogeny, serotypes, virulomes and plasmids were characterised for K. pneumoniae, and partially for Escherichia coli ST131, using various bioinformatic tools. Results Multifactorial diversity of the isolates reflected the patients’ clinical-epidemiological heterogeneity. The CPEs represented six species. Klebsiella pneumoniae was the most prevalent with 50 isolates and 15 sequence types (STs), mainly ST395, ST307, ST11, ST147 and ST23, producing NDM (-1/-5), OXA-48 (-48/-1242) or KPC (-2/-3)-like carbapenemases. Each of the STs produced groups of loosely related isolates, clusters of close relatives and/or unique isolates, correlating with K serotypes and carbapenemases. Many of these, especially NDM-1- and/or OXA-48-producing ST395 and ST307, were related to Russian organisms. Others, for example, NDM-1-producing ST11, clustered with those from Poland. Numerous K. pneumoniae isolates had specific virulence genes, including aerobactin iuc, largely due to spread of pNDM-MAR plasmids, showing both resistance and virulence. Two E. coli ST131 isolates belonged to clades B or C1 and produced KPC-3 or NDM-1, respectively. Conclusions Together with similar studies from Germany and The Netherlands, this work has documented broad dissemination of CPE in Ukraine, driven by a number of specific K. pneumoniae lineages circulating over a large territory of Eastern Europe. |
| format | Article |
| id | doaj-art-04055db04138491db47c1f3d5330f976 |
| institution | DOAJ |
| issn | 2193-8229 2193-6382 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Adis, Springer Healthcare |
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| series | Infectious Diseases and Therapy |
| spelling | doaj-art-04055db04138491db47c1f3d5330f9762025-08-20T03:00:58ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822025-01-0114240141910.1007/s40121-024-01097-9Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022–February 2023Marta Biedrzycka0Radosław Izdebski1Waleria Hryniewicz2Marek Gniadkowski3Dorota Żabicka4Department of Molecular Microbiology, National Medicines InstituteDepartment of Molecular Microbiology, National Medicines InstituteDepartment of Epidemiology and Clinical Microbiology, National Medicines InstituteDepartment of Molecular Microbiology, National Medicines InstituteDepartment of Epidemiology and Clinical Microbiology, National Medicines InstituteAbstract Introduction Despite a scarcity of data, before 2022 Ukraine was already considered a high-prevalence country for carbapenemase-producing Enterobacterales (CPE), and the situation has dramatically worsened during the full-scale war with Russia. The aim of this study was to analyse CPEs isolated in Poland from victims of war in Ukraine. Methods The study included 65 CPE isolates from March 2022 till February 2023, recovered in 36 Polish medical centres from 57 patients arriving from Ukraine, differing largely by age and reason for hospitalisation. All isolates were sequenced by MiSeq and ten Klebsiella pneumoniae isolates also by MinION. Taxonomy, clonality and resistomes were analysed for all CPEs, whereas phylogeny, serotypes, virulomes and plasmids were characterised for K. pneumoniae, and partially for Escherichia coli ST131, using various bioinformatic tools. Results Multifactorial diversity of the isolates reflected the patients’ clinical-epidemiological heterogeneity. The CPEs represented six species. Klebsiella pneumoniae was the most prevalent with 50 isolates and 15 sequence types (STs), mainly ST395, ST307, ST11, ST147 and ST23, producing NDM (-1/-5), OXA-48 (-48/-1242) or KPC (-2/-3)-like carbapenemases. Each of the STs produced groups of loosely related isolates, clusters of close relatives and/or unique isolates, correlating with K serotypes and carbapenemases. Many of these, especially NDM-1- and/or OXA-48-producing ST395 and ST307, were related to Russian organisms. Others, for example, NDM-1-producing ST11, clustered with those from Poland. Numerous K. pneumoniae isolates had specific virulence genes, including aerobactin iuc, largely due to spread of pNDM-MAR plasmids, showing both resistance and virulence. Two E. coli ST131 isolates belonged to clades B or C1 and produced KPC-3 or NDM-1, respectively. Conclusions Together with similar studies from Germany and The Netherlands, this work has documented broad dissemination of CPE in Ukraine, driven by a number of specific K. pneumoniae lineages circulating over a large territory of Eastern Europe.https://doi.org/10.1007/s40121-024-01097-9CarbapenemaseCarbapenemase-producing EnterobacteralesCPEKlebsiella pneumoniaeUkraine |
| spellingShingle | Marta Biedrzycka Radosław Izdebski Waleria Hryniewicz Marek Gniadkowski Dorota Żabicka Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022–February 2023 Infectious Diseases and Therapy Carbapenemase Carbapenemase-producing Enterobacterales CPE Klebsiella pneumoniae Ukraine |
| title | Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022–February 2023 |
| title_full | Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022–February 2023 |
| title_fullStr | Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022–February 2023 |
| title_full_unstemmed | Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022–February 2023 |
| title_short | Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022–February 2023 |
| title_sort | carbapenemase producing enterobacterales from patients arriving from ukraine in poland march 2022 february 2023 |
| topic | Carbapenemase Carbapenemase-producing Enterobacterales CPE Klebsiella pneumoniae Ukraine |
| url | https://doi.org/10.1007/s40121-024-01097-9 |
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