1627. Outbreaks of Klebsiella pneumoniae in Special Care Nurseries (SCN) in Jamaica: Role of Whole-Genome Sequencing
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Abstract Background Klebsiella pneumoniae is a frequent cause of neonatal sepsis and carries a high mortality rate in lower and middle-income countries (LMICs). From March-November 2015, two Jamaican hospitals experienced K. pneumoniae outbreaks in their Special Care Nurseries (SCNs). New admissions to both SCNs were temporarily halted while additional infection control strategies were implemented. 31 babies were infected, of which 15 died. International collaboration was requested to help investigate if the sepsis cases were nosocomial transmission, repeated introductions from the community, or both using whole-genome sequencing Methods We sequenced DNA from 19 outbreak isolates (n = 13 from Hospital A, n = 6 from Hospital B) on an Illumina HiSeq2500 instrument and assembled short-reads using SPAdes. We used ResFinder v3.1.0 to screen resistance genes and assigned MLSTs using in-house scripts. To compare the outbreak isolates, we selected a reference genome from among the assembled isolates, aligned raw reads using the Burrows–Wheeler Aligner (BWA), identified SNPs using GATK UnifiedGenotyper, and removed the recombined regions using Gubbins v2.3.4. We further contextualized the 19 outbreak isolates against a global collection of more than 300 K. pneumoniae genomes. Results All 13 isolates from Hospital A appeared to be from a single source. All were ST45 and encoded blaCTX-M-15, which confers extended-spectrum β-lactam (ESBL) resistance. Five of 6 isolates from Hospital B appeared to be from a separate, single source. These 5 isolates were ST268 and susceptible to most antibiotics. 1 isolate from Hospital B was ST628, encoded blaCTX-M-15, and grouped separately from other Hospital B outbreak isolates. Hospital A and B outbreak isolates formed independent, unique clades within a global K. pneumoniae collection. Conclusion Our findings indicate nosocomial transmission was responsible for both neonatal K. pneumoniae outbreaks, rather than repeat introductions from the community. The main sequence types we detected (ST45 and ST268) are not known pandemic clones and may circulate regionally. Multifaceted infection control measures were implemented for effectively halting outbreaks. Disclosures All authors: No reported disclosures.ABSTRACT Klebsiella pneumoniae sequence type (ST) 307, carrying bla KPC-3 , bla CTX-M-15 , bla OXA-1 , aac(6′)-Ib-cr , and qnrB 1 genes, is replacing the predominant hyperepidemic ST258 clone in Italy. Whole-genome and complete plasmid sequencing of one ST307 strain was performed and new features were identified.
clone (Java method)
Sequence (biology)
Strain (injury)
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Surveillance of general outbreaks of infectious gastroenteritis was introduced in 1998 by the Food Safety Authority of Ireland (FSAI), in co-operation with the eight health boards. A total of 67 general outbreaks of gastroenteritis in Ireland were reported to the FSAI in 1998 and 1999. Over 1900 people were ill as a result of these outbreaks. Four percent required hospitalisation and there were two deaths. The duration of the outbreaks varied between one day and 38 days. Salmonellae (44%) and small round structured viruses (SRSV) (12%) were the most commonly reported pathogens. In 25% of the outbreaks the aetiology was unknown. The commonest settings were restaurants, hotels and take-aways, which accounted for 45% (30/67) of all outbreaks. Sixteen percent of all outbreaks occurred in hospitals and residential institutions. Over half of the outbreaks were reported to be foodborne, 63% of which were due to various serotypes of Salmonella enterica. Eggs were implicated as the vehicle of infection in 13% of all outbreaks. An infected food handler was identified in almost one third of outbreaks, although it could not be established if this had contributed directly to the outbreak.
Salmonella Food Poisoning
Etiology
Salmonella enterica
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Etiology
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Abstract Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party. We conducted 2 analytical studies: a case–control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19–positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed. These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe.
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Treatment of infections with Klebsiella pneumoniae strains producing extended-spectrum beta-lactamases (ESBLs) is challenging due to the coexistence of multiple resistance mechanisms and the hypervirulent variant. Therefore, new targets or more effective treatment options aimed at ESBL-producing Klebsiella pneumoniae are urgently needed.Here, we collected ESBL-producing and non-ESBL Klebsiella pneumoniae isolates and studied their differences from a proteomic point of view.We revealed treA, wza, gnd, rmlA, rmlC, rmlD, galE, aceE, and sucD as important virulence-related proteins in ESBL-producing Klebsiella pneumoniae, distinct from those in non-ESBL strains.Our findings provide plausible anti-virulence targets and suggest new therapeutic avenues against ESBL-producing Klebsiella pneumoniae.
Klebsiella
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Abstract Background The origins of Ebola disease outbreaks remain enigmatic. Historically outbreaks have been attributed to spillover events from wildlife. However, recent data suggest that some outbreaks may originate from human-to-human transmission of prior outbreak strains instead of spillover. Clarifying the origins of Ebola disease outbreaks could improve detection and mitigation of future outbreaks. Methods We reviewed the origins of all Ebola disease outbreaks from 1976 to 2022 to analyze the earliest cases and characteristics of each outbreak. The epidemiology and phylogenetic relationships of outbreak strains were used to further identify the likely source of each outbreak. Results From 1976 to 2022 there were 35 Ebola disease outbreaks with 48 primary/index cases. While the majority of outbreaks were associated with wildlife spillover, resurgence of human-to-human transmission could account for roughly a quarter of outbreaks caused by Ebola virus. Larger outbreaks were more likely to lead to possible resurgence, and nosocomial transmission was associated with the majority of outbreaks. Conclusions While spillover from wildlife has been a source for many Ebola disease outbreaks, multiple outbreaks may have originated from flare-ups of prior outbreak strains. Improving access to diagnostics as well as identifying groups at risk for resurgence of ebolaviruses will be crucial to preventing future outbreaks.
Ebolavirus
Ebola Hemorrhagic Fever
Spillover effect
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Objective To understand the characteristics of influenza-like illness(ILI) outbreaks in Yunnan province and provide evidence for the development of scientific and effective control measures.Methods The data of ILI outbreaks in Yunnan in 2009 were collected and analyzed Results Totally 72 ILI outbreaks occurred in Yunnan,resulting in 7 628 ILI cases.The attack rate ranged from 1.79% to 49.45%.The disease occurred all the year round with peak in Autumn.Twenty six outbreaks occurred in Zhaotong,Sixty eight outbreaks occurred in schools.The influenza viruses were isolated from the cases in 37 out of 54 outbreaks,including influenza H3N2 virus(in 12 outbreaks),influenza B virus(in 11 outbreaks),2009 pandemic influenza A(H1N1) virus(in 9 outbreaks) and influenza A(H1N1) virus(in 5 outbreaks).The interval between the finding of the first case and the response and the duration of epidemic was positive correlated.(r=0.896,P0.05).Conclusion More ILI outbreaks occurred in Yunnan in 2009 than in 2008,and 94% of the outbreaks occurred in schools.It is necessary to strengthen the ILI outbreak surveillance and reporting in schools and improve the sample collection and laboratory detection.
Influenza-like illness
Attack rate
Pandemic
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Objective To establish the proteomic diagnostic model for Klebsiella pneumoniae strains producing extended spectrum beta-lactamases(ESBLs) and search for a rapid method to identify them. Methods Klebsiella pneumoniae proteins were detected by the PBS Ⅱ/C protein fingerprint spectrometer and Au protein chip.The differentially expressed proteins of Klebsiella pneumoniae ESBLs positive and negative strains were analyzed and an artificial neural network(ANN) model of Klebsiella pneumoniae ESBLs producing strains was established and validated. Results Totally,47 protein peaks were detected for the moleculars with mass-to-charge ratio(m/z) within the range of 2,000-20,000.The peaks with m/z of 5,985.5,8,361.6 and 9,169.8 were screened by ANN as the protein spectrum model of Klebsiella pneumoniae ESBLs producing strains.The validation result of the model indicated that the sensitivity was 96.88% and the specificity was 93.62%. Conclusions The protein spectrum model established by this study can identify Klebsiella pneumoniae ESBLs producing strains accurately and rapidly.It is worth further studying.
Klebsiella
Protein chip
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All outbreaks of infectious intestinal disease reported to the authorities were entered on a computer database with outbreak control teams being established to investigate larger or more significant incidents. The outbreak database and, when set up, the notes of outbreak team meetings were examined for the 279 outbreaks reported in a three-year period (2003-2005). Faeces specimens submitted as part of an outbreak were examined for microbial pathogens and the results cross-matched to the outbreak number. Almost half of the general outbreaks reported (137) occurred in long-term care facilities for the elderly, 51 outbreaks were recorded in hospitals and 31 occurred in the wider community. In 76 outbreaks no specimen was logged. A microbial cause was confirmed in about one-third of outbreaks, with noroviruses being the most common (19%). Salmonellas accounted for 12 of the 21 community outbreaks linked to social events and all were foodborne. Suggestions for improving notification and surveillance are discussed.
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Objective To analyze the surveillance results of outbreaks of influenza-like illness(ILI) in Shenzhen from 2010 to 2011,to know the epidemic trend of ILI,and to provide a scientific basis for ILI prevention and treatment. Methods The study was conducted on the surveillance data of ILI outbreaks in Shenzhen from 2010 to 2011. Results A total of 226 ILI outbreaks were reported in Shenzhen from 2010 to 2011.2,026 cases of ILI were identified during the outbreaks,with the average incidence rate of 14.2%.64 ILI outbreaks were reported in December,followed by 56 outbreaks in March and 39 outbreaks in April.201 out of 226 outbreaks were tested positive for influenza,consisting of 171 outbreaks for type B(85.0%),17 outbreaks for novel H1N1(8.5%),and 13 outbreaks for seasonal type A(6.5%). Conclusions The intensity of influenza circulation was medium during the period of 2010-2011,and the peak of influenza activity occurred in March,April and December.
Influenza-like illness
Attack rate
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