Hospital and Healthcare Pathogens
A Genomic Investigation of Carbapenemase-producing Enterobacteriaceae (CPE) in Victoria and Australia
Carbapenem-resistant Enterobacteriaceae such as KPC-producing Klebsiella pneumoniae are among the top antibiotic-resistant threats worldwide. Outbreaks of these extensively drug-resistant organisms have been associated with considerable morbidity and up to 50% in-hospital mortality. Although carbapenem-resistant K. pneumoniae have been reported in Australia in the context of international travel, no major local outbreaks have previously been reported.
Following a substantial increase in the number of carbapenem-resistant K. pneumoniae isolates referred to the Microbiological Diagnostic Unit Public Health Laboratory (MDU PHL) in Victoria, a whole genome sequencing project was initiated in order to (a) determine the genetic relatedness of these isolates, (b) to ascertain whether ongoing transmission of local KPC-producing K. pneumoniae is occurring in Victoria and (c) to identify which if any transmission networks are involved in the spread of carbapenem-resistant K. pneumoniae isolates within Victoria.
Our work on CPE also involves developing an understanding of the epidemiology of carbapenemases in Australia, including how they are transferred and exchanged between different bacteria, how frequently they are transmitted between patients, and therapeutic options to treat patients who develop infections due to CPE. In conjunction with the Victorian Department of Health & Human Services, we have established a state-wide surveillance program for CPE using WGS-based surveillance.
As part of the Australian Commission for Safety & Quality in Healthcare’s national alert system for Critical Antimicrobial Resistances (CARAlert), we are also investigating the use of WGS to monitor isolates for critical antimicrobial resistance elements.
Department of Health & Human Services (DHHS), Victoria, Australia
Australian Group on Antimicrobial Resistance (AGAR), Australia
Kwong JC, Lane CR, Romanes F, Goncalves da Silva A, Easton M, Cronin K, et al. PeerJ. 2018;6:e4210