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

Abstract

<b>Introduction.</b> Transmission of Enterobacterales in neonatal intensive care units (NICU) can cause outbreaks of colonization and invasive infections among neonates. Two clusters of nosocomial transmission of <i>Klebsiella pneumoniae</i> identified by MALDI-ToF mass-spectrometry were suspected at two NICUs in July and August 2016.<b>Aim.</b> To assess the potential transmission of <i>K. pneumoniae</i> among neonates.<b>Methodology.</b> Whole-genome sequencing (WGS) was performed of <i>K. pneumoniae</i> isolates obtained through targeted surveillance of patients and environmental sampling.<b>Results.</b> WGS data revealed that patient and environmental isolates represented two species, <i>K. pneumoniae</i> and <i>K. variicola</i>. Core-genome multi-locus sequence typing (cgMLST) of the isolates identified three separate transmission clusters, in Hospital A a cluster of <i>K. pneumoniae</i> isolates in 12 children and two environmental samples and a second cluster of <i>K. variicola</i> isolates in five children. In Hospital B a cluster of <i>K. pneumoniae</i> isolates from three children and five unrelated isolates of <i>K. pneumoniae</i> and two unrelated isolates of <i>K. variicola</i> were found.<b>Conclusion.</b> <i>K. variicola</i> can cause hospital outbreaks of colonization and infection similar to other <i>Klebsiella</i> spp.Preliminary results from this study were presented at the 27th European Congress of Clinical Microbiology and Infectious Diseases, April 22-25, 2018, Vienna, Austria.