Whole-Genome Comparative Analysis of Two Carbapenem-Resistant ST-258 Klebsiella pneumoniae Strains Isolated during a North-Eastern Ohio Outbreak: Differences within the High Heterogeneity Zones.

Abstract	Klebsiella pneumoniae has become one of the most dangerous causative agents of hospital infections due to the acquisition of resistance to carbapenems, one of the last resort families of antibiotics. Resistance is usually mediated by carbapenemases coded for by different classes of genes. A prolonged outbreak of carbapenem-resistant K. pneumoniae infections has been recently described in northeastern Ohio. Most strains isolated from patients during this outbreak belong to MLST sequence type 258 (ST258). To understand more about this outbreak two isolates (strains 140 and 677), one of them responsible for a fatal infection, were selected for genome comparison analyses. Whole genome map and sequence comparisons demonstrated that both strains are highly related showing 99% average nucleotide identity. However, the genomes differ at the so-called high heterogeneity zone (HHZ) and other minor regions. This study identifies the potential value of the HHZ as a potential marker for K. pneumoniae clinical and epidemiological studies.
Authors	María Soledad Ramirez, Gang Xie, German M Traglia, Shannon L Johnson, Karen W Davenport, David van Duin, Azam Ramazani, Federico Perez, Michael R Jacobs, David J Sherratt, Robert A Bonomo, Patrick S G Chain, Marcelo E Tolmasky
Journal	Genome biology and evolution (Genome Biol Evol) Vol. 8 Issue 6 Pg. 2036-43 (07 03 2016) ISSN: 1759-6653 [Electronic] England
PMID	27289094 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural)
Copyright	© The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.
Chemical References	Anti-Bacterial Agents Carbapenems
Topics	Anti-Bacterial Agents (therapeutic use) Carbapenems (therapeutic use) Cross Infection Disease Outbreaks Drug Resistance, Bacterial (genetics) Genetic Heterogeneity Genome, Bacterial Humans Klebsiella Infections (drug therapy, genetics, microbiology) Klebsiella pneumoniae (genetics, pathogenicity)

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