Whole genome sequencing to track a hospital outbreak of carbapenem-resistant Klebsiella pneumoniae

Tuesday, October 09, 2012 — Poster Session I
1:00 p.m. – 3:00 p.m	Natcher Conference Center, Building 45	NIGMS	INFECTDIS-6

* FARE Award Winner

Authors

• ES Snitkin
• AM Zelazny
• PJ Thomas
• F Stock
• DK Henderson
• TN Palmore
• JA Segre

Abstract

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 National Institutes of Health Clinical Center experienced an outbreak of carbapenem-resistant K. pneumoniae that affected 18 patients, 10 of who died. Whole-genome sequencing was performed on K. pneumoniae isolates to gain insight into how the outbreak progressed, in spite of early implementation of infection control procedures. Integrated genomic and epidemiological analysis traced the outbreak back to three independent transmissions from a single patient, who was discharged three weeks before the next case became clinically apparent. Additional genomic comparisons provided evidence for unexpected transmission routes, with subsequent mining of epidemiological data providing 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.

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