[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]
Volume 25, Number 4—April 2019 / Research
Klebsiella pneumoniae ST307 with blaOXA-181, South Africa, 2014–2016
Michelle Lowe1, Marleen M. Kock, Jennifer Coetzee, Ebrahim Hoosien, Gisele Peirano, Kathy-Ann Strydom, Marthie M. Ehlers, Nontombi M. Mbelle, Elena Shashkina, David B. Haslam, Puneet Dhawan, Robert J. Donnelly, Liang Chen1, Barry N. Kreiswirth, and Johann D.D. Pitout
Author affiliations: University of Pretoria, Pretoria, South Africa (M. Lowe, M.M. Kock, K.-A. Strydom, M.M. Ehlers, N.M. Mbelle, J.D.D. Pitout); National Health Laboratory Service, Pretoria (M. Lowe, M.M. Kock, K.-A. Strydom, M.M. Ehlers, N.M. Mbelle); Ampath Laboratories, Pretoria (J. Coetzee, E. Hoosien); Calgary Laboratory Services, Calgary, Alberta, Canada (G. Peirano, J.D.D. Pitout); University of Calgary, Calgary (G. Peirano, J.D.D. Pitout); Rutgers University, Newark, New Jersey, USA (E. Shashkina, L. Chen, B.N. Kreiswirth); Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA (D.B. Haslam); New Jersey Medical School, Newark (P. Dhawan, R.J. Donnelly)
Klebsiella pneumoniae sequence type (ST) 307 is an emerging global antimicrobial drug–resistant clone. We used whole-genome sequencing and PCR to characterize K. pneumoniae ST307 with oxacillinase (OXA) 181 carbapenemase across several private hospitals in South Africa during 2014–16. The South Africa ST307 belonged to a different clade (clade VI) with unique genomic characteristics when compared with global ST307 (clades I–V). Bayesian evolution analysis showed that clade VI emerged around March 2013 in Gauteng Province, South Africa, and then evolved during 2014 into 2 distinct lineages. K. pneumoniae ST307 clade VI with OXA-181 disseminated over a 15-month period within 42 hospitals in 23 cities across 6 northeastern provinces, affecting 350 patients. The rapid expansion of ST307 was most likely due to intrahospital, interhospital, intercity, and interprovince movements of patients. This study highlights the importance of molecular surveillance for tracking emerging antimicrobial clones.
Keywords: Antibiotics; Drugs Resistance; Carbapenem; Oxacillin; Klebsiella pneumoniae; South Africa.