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Prolonged transmission of a resistant bacterial strain in a Northern California hospital

Researchers have used whole genome sequencing (WGS) to demonstrate transmission of a single bacterial strain that possessed a carbapenem-resistance gene in a northern California hospital. The gene armed the bacteria with resistance to carbapenems, a type of antimicrobial drug reserved as a last-line treatment for serious infections. The research is presented on Sunday, June 23rd at ASM Microbe, the annual meeting of the American Society for Microbiology.

Epidemiologists from the local public health department and the California Department of Public Health (CDPH) collaborated with laboratory scientists from the CDPH Microbial Diseases Laboratory (MDL) to characterize the strain and identify potential transmission pathways in combination with epidemiologic information.

The bacterial strain persisted in the hospital for over 3 years, potentially due to transmission from patient to patient combined with lengthy stays in the hospital intensive care unit (ICU). "Our investigation highlights the importance of regular epidemiological and microbiological monitoring of resistant strains in hospitals and the use of the advanced molecular technologies to track their spread," said Varvara Kozyreva, Ph.D. Genotyping Unit Chief, Microbial Diseases Laboratory Program, California Department of Public Health.

"[...] WGS allowed us to understand and demonstrate connections among the patients over a multiple year time period, which would not have been possible using epidemiologic information alone," said Dr. Kozyreva. WGS also showed that this particular bacterial strain's carbapenem-resistance gene appeared to be located on the chromosome. Normally, such resistance genes are located on additional "mobile" DNA pieces called plasmids, that can be transferred between different strains (and even different species) of bacteria.

Original Submission