Whole-Genome Sequencing Reveals Diversity of Carbapenem-Resistant Pseudomonas aeruginosa Collected Through the Emerging Infections Program

Background: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a frequent cause of healthcare-associated infections (HAIs). The CDC Emerging Infections Program (EIP) conducted population and laboratory-based surveillance of CRPA in selected areas in 8 states from August 1, 2016, through July 31,...

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Published in:	Infection control and hospital epidemiology 2020-10, Vol.41 (S1), p.s513-s514
Main Authors:	Stanton, Richard, Daniels, Jonathan, Breaker, Erin, Campbell, Davina, Lutgring, Joseph, Karlsson, Maria, Schutz, Kyle, Jacob, Jesse, Wilson, Lucy, Vaeth, Elisabeth, Li, Linda, Lynfield, Ruth, Phipps, Erin C., Hancock, Emily, Dumyati, Ghinwa, Tsay, Rebecca, Cassidy, P. Maureen, Mounsey, Jacquelyn, Grass, Julian, Walters, Maroya, Halpin, Alison
Format:	Article
Language:	eng
Subjects:	Antibiotics Cloning Disease control Epidemiology Genomes Health surveillance Infections Mutation Surveillance
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Summary:	Background: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a frequent cause of healthcare-associated infections (HAIs). The CDC Emerging Infections Program (EIP) conducted population and laboratory-based surveillance of CRPA in selected areas in 8 states from August 1, 2016, through July 31, 2018. We aimed to describe the molecular epidemiology and mechanisms of resistance of CRPA isolates collected through this surveillance. Methods: We defined a case as the first isolate of P. aeruginosa resistant to imipenem, meropenem, or doripenem from the lower respiratory tract, urine, wounds, or normally sterile sites identified from a resident of the EIP catchment area in a 30-day period; EIP sites submitted a systematic random sample of isolates to CDC for further characterization. Of 1,021 CRPA clinical isolates submitted, 707 have been sequenced to date using an Illumina MiSeq. Sequenced genomes were classified using the 7-gene multilocus sequence typing (MLST) scheme, and a core genome MLST (cgMLST) scheme was used to determine phylogeny. Antimicrobial resistance genes were identified using publicly available databases, and chromosomal mechanisms of carbapenem resistance were determined using previously validated genetic markers. Results: There were 189 sequence types (STs) among the 707 sequenced genomes (Fig. 1). The most frequently occurring were high-risk clones ST235 (8.5%) and ST298 (4.7%), which were found across all EIP sites. Carbapenemase genes were identified in 5 (
ISSN:	0899-823X 1559-6834