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      Tracking a hospital outbreak of carbapenem-resistant Klebsiella pneumoniae with whole-genome sequencing.

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          Abstract

          The Gram-negative bacteria Klebsiella pneumoniae is a major cause of nosocomial infections, primarily among immunocompromised patients. The emergence of strains resistant to carbapenems has left few treatment options, making infection containment critical. In 2011, the U.S. National Institutes of Health Clinical Center experienced an outbreak of carbapenem-resistant K. pneumoniae that affected 18 patients, 11 of whom died. Whole-genome sequencing was performed on K. pneumoniae isolates to gain insight into why the outbreak progressed despite early implementation of infection control procedures. Integrated genomic and epidemiological analysis traced the outbreak to three independent transmissions from a single patient who was discharged 3 weeks before the next case became clinically apparent. Additional genomic comparisons provided evidence for unexpected transmission routes, with subsequent mining of epidemiological data pointing to possible explanations for these transmissions. Our analysis demonstrates that integration of genomic and epidemiological data can yield actionable insights and facilitate the control of nosocomial transmission.

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          Author and article information

          Journal
          Sci Transl Med
          Science translational medicine
          American Association for the Advancement of Science (AAAS)
          1946-6242
          1946-6234
          Aug 22 2012
          : 4
          : 148
          Affiliations
          [1 ] National Human Genome Research Institute, Bethesda, MD 20892, USA.
          Article
          4/148/148ra116 NIHMS424107
          10.1126/scitranslmed.3004129
          3521604
          22914622
          cb0ae09f-c61b-47dd-a0c3-ef5982b8a4a6

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