Bacteria are becoming increasingly resistant to antibiotic drugs, and some bacteria are now resistant to some of our last-resort antibiotics, a class of drug known as carbapenems. Carbapenem resistance is encoded by several genes, or packages of genetic material, which can be passed from one bacterial bug to another. The bacteria do this by sharing pieces of DNA (genetic material) known as plasmids, which contain these carbapenem resistance genes. Common carbapenem resistance genes include a gene known as “KPC”.
Tracking outbreaks of carbapenem-resistant bugs can be tricky, but the recent development of a USB-stick- sized device known as the Nanopore MinION has proved helpful. This device is able to sequence, or decode, the entire genetic content of bugs so that we can work out whether they are likely to have spread from patient- to-patient in any given outbreak.
In this study, an outbreak of carbapenem-resistant bugs causing infections on a liver unit in Leeds was investigated with the Nanopore MinION. Researchers were able to show that the outbreak was highly complex, with evidence for transmission of resistance plasmids between bugs, and resistant bugs between patients. Using sequence data from other centres, we were also able to show that transmission of carbapenem-resistant bugs was occurring more widely than just in the liver unit.
Understanding resistance genes spread is crucial to developing effective interventions to limit how quickly this occurs
Whole genome sequencing, using methods such as the Nanopore MinION, can be very helpful in understanding how resistance genes spread
Resistance gene spread in bacteria is a multi-centre phenomenon, and efforts to target it must consider the movement of patient between healthcare institutions
The research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Oxford University in partnership with Public Health England (PHE)
Covert dissemination of carbapenemase-producing Klebsiella pneumoniae (KPC) in a successfully controlled outbreak: long and short-read whole genome sequencing demonstrate multiple genetic modes of transmission.
You can read more work studying how bacteria can share plasmids and resistance genes here:
This research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Oxford University in partnership with Public Health England (PHE) [HPRU-2012–10041].