Contribution of nosocomial transmission to Klebsiella pneumoniae neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal dat
3 hours ago
- #Klebsiella pneumoniae
- #neonatal sepsis
- #nosocomial transmission
- Klebsiella pneumoniae is the leading cause of neonatal sepsis in low- and middle-income countries in Africa and Asia.
- An observational study using pathogen genomics and temporal data estimated nosocomial transmission clusters.
- Analysis of 1,523 isolates from 27 neonatal units in 13 countries found 156 transmission clusters.
- 68% of neonatal infections (1,035 cases) were part of nosocomial transmission clusters.
- At least 57.7% of infections (879 cases) were acquired via nosocomial transmission after excluding index cases.
- Results were robust across different genetic distance thresholds and temporal thresholds of 2 to 8 weeks.
- Most isolates were ESBL producers (90.9%), and 172 multi-locus sequence types (STs) were identified.
- Fourteen STs, including globally recognized multidrug-resistant lineages, were linked to transmission clusters across multiple units, accounting for two-thirds of infections.
- Carriage of carbapenemase and ESBL genes was significantly associated with transmission.
- Improved infection prevention and control in neonatal units could reduce the sepsis burden.