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Klebsiella variicola causing nosocomial transmission among neonates - an emerging pathogen?

Ellen Piepenbrock1, Paul G Higgins2,1, Julia Wille2,1

  • 1Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Germany.

Journal of Medical Microbiology
|March 4, 2020
PubMed

Insights

Klebsiella variicola, not just K. pneumoniae, can cause hospital outbreaks in neonatal intensive care units (NICUs). Whole-genome sequencing confirmed transmission clusters of both species, highlighting K. variicola as a significant pathogen in neonates.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Neonatal Care

Background:

  • Enterobacterales transmission in neonatal intensive care units (NICUs) poses risks for neonates, leading to colonization and invasive infections.
  • Two suspected nosocomial transmission clusters of Klebsiella pneumoniae were identified in NICUs during July-August 2016.

Purpose of the Study:

  • To investigate and assess the potential transmission of Klebsiella pneumoniae among neonates in NICUs.
  • To determine the species involved in suspected transmission events using advanced genomic techniques.

Main Methods:

  • Whole-genome sequencing (WGS) was employed to analyze Klebsiella isolates from patients and environmental samples.
  • Core-genome multi-locus sequence typing (cgMLST) was used to identify transmission clusters and genetic relatedness.

Main Results:

  • WGS identified two species: Klebsiella pneumoniae and Klebsiella variicola.
  • Three distinct transmission clusters were identified: one Klebsiella pneumoniae cluster in Hospital A (12 patients, 2 environmental samples), one Klebsiella variicola cluster in Hospital A (5 patients), and one Klebsiella pneumoniae cluster in Hospital B (3 patients).
  • Hospital B also had unrelated Klebsiella pneumoniae and Klebsiella variicola isolates, indicating diverse microbial presence.

Conclusions:

  • Klebsiella variicola is capable of causing hospital outbreaks of colonization and infection, similar to other Klebsiella species.
  • Genomic surveillance is crucial for identifying and controlling Klebsiella outbreaks in neonatal populations.
Keywords:
Klebsiella pneumoniaeMALDI-ToFWhole genome sequencing (WGS)core-genome multilocus sequence typing (cgMLST)outbreak

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