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Genome-wide analysis and longitudinal study of Klebsiella pneumoniae in Portugal : tracing the evolution and spread of carbapenem resistance

2025-11Contributo em revista Acesso aberto
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datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorElias, Rita
dc.contributor.authorPhelan, Jody E.
dc.contributor.authorLito, Luís
dc.contributor.authorCaneiras, Cátia
dc.contributor.authorMarques, Cátia
dc.contributor.authorPinto, Margarida
dc.contributor.authorCavaco-Silva, Patrícia
dc.contributor.authorFerreira, Helena
dc.contributor.authorPomba, Constança
dc.contributor.authorSilva, Gabriela J. da
dc.contributor.authorSaavedra, Maria José
dc.contributor.authorCoelho, Rosário
dc.contributor.authorLourinho, Rita
dc.contributor.authorGonçalves, Luísa
dc.contributor.authorHinthong, Woranich
dc.contributor.authorRosa, Maria João
dc.contributor.authorMelo-Cristino, José
dc.contributor.authorCampino, Susana
dc.contributor.authorPortugal, Isabel
dc.contributor.authorDuarte, Aida
dc.contributor.authorPerdigão, João
dc.date.accessioned2026-05-08T14:41:28Z
dc.date.available2026-05-08T14:41:28Z
dc.date.issued2025-11
dc.description.abstractBackground: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has high incidence in Portugal, causing severe and often fatal infections. Objectives: Characterize the evolutionary history and epidemiology of CRKP in Portugal over a 40-year period. Methods: WGS was performed using the Illumina platform. In silico multilocus sequence typing, surface antigen characterization, and resistance gene detection were subsequently carried out. Core and pan-genome analyses were conducted using Roary. Genomic clusters (GCs) were identified based on a 21-SNP threshold. To estimate the divergence times of the most prevalent sequence types (ST) in the dataset, Bayesian evolutionary analysis was performed using BEAST. Results: Nineteen GCs harboring carbapenemases were identified. The blaKPC-3 gene was the most prevalent carbapenemase, linked to strains circulating in both hospital and community settings, with dissemination patterns at regional, interregional, and international levels. ST15 was the most established sequence type in Portugal, with nine distinct GCs identified in both clinical and environmental samples. Towards the end of 2010s, ST147 and ST13 were responsible for significant outbreaks associated with blaKPC-3. Conclusions: This study underscores the value of genomic-based surveillance in understanding the evolution of high-risk clones coupled with the spread of AMR determinants. The data obtained highlights a shift in ST predominance across the country from an ST15-dominated period and strongly associated with ESBL dissemination, to the emergence of ST147 and ST13 CRKP clones, the latter associated with international transmission. This work further stresses the importance of cross-border surveillance efforts to monitor the emergence and dissemination of CRKP strains and inform risk assessment and prevention.eng
dc.identifier.citationElias, R., Phelan, J. E., Lito, L., Caneiras, C., Marques, C., Pinto, M., Cavaco-Silva, P., Ferreira, H., Pomba, C., Da Silva, G. J., Saavedra, M. J., Coelho, R., Lourinho, R., Gonçalves, L., Hinthong, W., Rosa, M. J., Melo-Cristino, J., Campino, S., Portugal, I., Duarte, A., … Perdigão, J. (2025). Genome-wide analysis and longitudinal study of Klebsiella pneumoniae in Portugal: Tracing the evolution and spread of carbapenem resistance. International journal of antimicrobial agents, 66(5), 107583. https://doi.org/10.1016/j.ijantimicag.2025.107583
dc.identifier.doi10.1016/j.ijantimicag.2025.107583
dc.identifier.issn1872-7913
dc.identifier.urihttp://hdl.handle.net/10400.26/63048
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://doi.org/10.1016/j.ijantimicag.2025.107583
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectCarbapenem-resistant
dc.subjectKlebsiella pneumoniae
dc.subjectPhylogenetic history
dc.subjectDissemination dynamics
dc.subjectAntimicrobial resistance surveillance
dc.titleGenome-wide analysis and longitudinal study of Klebsiella pneumoniae in Portugal : tracing the evolution and spread of carbapenem resistanceeng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.issue5
oaire.citation.startPage107583
oaire.citation.titleInternational Journal of Antimicrobial Agents
oaire.citation.volume66
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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