Tracing the transmission of carbapenem-resistant Enterobacterales at the patient: ward environmental nexus
Abstract Introduction Colonisation and infection with Carbapenem-resistant Enterobacterales (CRE) in healthcare settings poses significant risks, especially for vulnerable patients. Genomic analysis can be used to trace transmission routes, supporting antimicrobial stewardship and informing infectio...
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BMC
2024-12-01
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| Series: | Annals of Clinical Microbiology and Antimicrobials |
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| Online Access: | https://doi.org/10.1186/s12941-024-00762-8 |
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| author | Linzy Elton Alan Williams Shanom Ali Jelena Heaphy Vicky Pang Liam Commins Conor O’Brien Özge Yetiş Estelle Caine Imogen Ward Monika Muzslay Samuel Yui Kush Karia Ellinor Shore Sylvia Rofael Damien J. F. Mack Timothy D. McHugh Emmanuel Q. Wey |
| author_facet | Linzy Elton Alan Williams Shanom Ali Jelena Heaphy Vicky Pang Liam Commins Conor O’Brien Özge Yetiş Estelle Caine Imogen Ward Monika Muzslay Samuel Yui Kush Karia Ellinor Shore Sylvia Rofael Damien J. F. Mack Timothy D. McHugh Emmanuel Q. Wey |
| author_sort | Linzy Elton |
| collection | DOAJ |
| description | Abstract Introduction Colonisation and infection with Carbapenem-resistant Enterobacterales (CRE) in healthcare settings poses significant risks, especially for vulnerable patients. Genomic analysis can be used to trace transmission routes, supporting antimicrobial stewardship and informing infection control strategies. Here we used genomic analysis to track the movement and transmission of CREs within clinical and environmental samples. Methods 25 isolates were cultured from clinical patient samples or swabs, that tested positive for OXA-48-like variants using the NG-Test® CARBA-5 test and whole genome sequenced (WGS) using Oxford Nanopore Technologies (ONT). 158 swabs and 52 wastewater samples were collected from the ward environment. 60 isolates (matching clinical isolate genera; Klebsiella, Enterobacter, Citrobacter and Escherichia) were isolated from the environmental samples using selective agar. Metagenomic sequencing was undertaken on 36 environmental wastewater and swab samples. Results 21/25 (84%) clinical isolates had > 1 bla OXA gene and 19/25 (76%) harboured > 1 bla NDM gene. Enterobacterales were most commonly isolated from environmental wastewater samples 27/52 (51.9%), then stick swabs 5/43 (11.6%) and sponge swabs 5/115 (4.3%). 11/60 (18%) environmental isolates harboured > 1 bla OXA gene and 1.9% (1/60) harboured bla NDM-1 . bla OXA genes were found in 2/36 (5.5%) metagenomic environmental samples. Conclusions Potential for putative patient-patient and patient-ward transmission was shown. Metagenomic sampling needs optimization to improve sensitivity. |
| format | Article |
| id | doaj-art-c7f3454413c1492baa365f6dd7f3fbbd |
| institution | DOAJ |
| issn | 1476-0711 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Annals of Clinical Microbiology and Antimicrobials |
| spelling | doaj-art-c7f3454413c1492baa365f6dd7f3fbbd2025-08-20T02:40:14ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112024-12-0123111510.1186/s12941-024-00762-8Tracing the transmission of carbapenem-resistant Enterobacterales at the patient: ward environmental nexusLinzy Elton0Alan Williams1Shanom Ali2Jelena Heaphy3Vicky Pang4Liam Commins5Conor O’Brien6Özge Yetiş7Estelle Caine8Imogen Ward9Monika Muzslay10Samuel Yui11Kush Karia12Ellinor Shore13Sylvia Rofael14Damien J. F. Mack15Timothy D. McHugh16Emmanuel Q. Wey17The Centre for Clinical Microbiology, University College LondonDepartment of Infection Sciences, Health Services LaboratoriesThe Centre for Clinical Microbiology, University College LondonRoyal Free London NHS Foundation TrustRoyal Free London NHS Foundation TrustRoyal Free London NHS Foundation TrustRoyal Free London NHS Foundation TrustThe Centre for Clinical Microbiology, University College LondonEnvironmental Research Laboratory, University College London Hospitals NHS Foundation TrustEnvironmental Research Laboratory, University College London Hospitals NHS Foundation TrustEnvironmental Research Laboratory, University College London Hospitals NHS Foundation TrustEnvironmental Research Laboratory, University College London Hospitals NHS Foundation TrustEnvironmental Research Laboratory, University College London Hospitals NHS Foundation TrustDepartment of Infection Sciences, Health Services LaboratoriesThe Centre for Clinical Microbiology, University College LondonRoyal Free London NHS Foundation TrustThe Centre for Clinical Microbiology, University College LondonThe Centre for Clinical Microbiology, University College LondonAbstract Introduction Colonisation and infection with Carbapenem-resistant Enterobacterales (CRE) in healthcare settings poses significant risks, especially for vulnerable patients. Genomic analysis can be used to trace transmission routes, supporting antimicrobial stewardship and informing infection control strategies. Here we used genomic analysis to track the movement and transmission of CREs within clinical and environmental samples. Methods 25 isolates were cultured from clinical patient samples or swabs, that tested positive for OXA-48-like variants using the NG-Test® CARBA-5 test and whole genome sequenced (WGS) using Oxford Nanopore Technologies (ONT). 158 swabs and 52 wastewater samples were collected from the ward environment. 60 isolates (matching clinical isolate genera; Klebsiella, Enterobacter, Citrobacter and Escherichia) were isolated from the environmental samples using selective agar. Metagenomic sequencing was undertaken on 36 environmental wastewater and swab samples. Results 21/25 (84%) clinical isolates had > 1 bla OXA gene and 19/25 (76%) harboured > 1 bla NDM gene. Enterobacterales were most commonly isolated from environmental wastewater samples 27/52 (51.9%), then stick swabs 5/43 (11.6%) and sponge swabs 5/115 (4.3%). 11/60 (18%) environmental isolates harboured > 1 bla OXA gene and 1.9% (1/60) harboured bla NDM-1 . bla OXA genes were found in 2/36 (5.5%) metagenomic environmental samples. Conclusions Potential for putative patient-patient and patient-ward transmission was shown. Metagenomic sampling needs optimization to improve sensitivity.https://doi.org/10.1186/s12941-024-00762-8Antimicrobial resistanceOXA48NDMPlasmidsTransmissionEnvironment |
| spellingShingle | Linzy Elton Alan Williams Shanom Ali Jelena Heaphy Vicky Pang Liam Commins Conor O’Brien Özge Yetiş Estelle Caine Imogen Ward Monika Muzslay Samuel Yui Kush Karia Ellinor Shore Sylvia Rofael Damien J. F. Mack Timothy D. McHugh Emmanuel Q. Wey Tracing the transmission of carbapenem-resistant Enterobacterales at the patient: ward environmental nexus Annals of Clinical Microbiology and Antimicrobials Antimicrobial resistance OXA48 NDM Plasmids Transmission Environment |
| title | Tracing the transmission of carbapenem-resistant Enterobacterales at the patient: ward environmental nexus |
| title_full | Tracing the transmission of carbapenem-resistant Enterobacterales at the patient: ward environmental nexus |
| title_fullStr | Tracing the transmission of carbapenem-resistant Enterobacterales at the patient: ward environmental nexus |
| title_full_unstemmed | Tracing the transmission of carbapenem-resistant Enterobacterales at the patient: ward environmental nexus |
| title_short | Tracing the transmission of carbapenem-resistant Enterobacterales at the patient: ward environmental nexus |
| title_sort | tracing the transmission of carbapenem resistant enterobacterales at the patient ward environmental nexus |
| topic | Antimicrobial resistance OXA48 NDM Plasmids Transmission Environment |
| url | https://doi.org/10.1186/s12941-024-00762-8 |
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