Investigating Pseudomonas aeruginosa population structure and frequency of cross-infection in UK cystic fibrosis clinics - a reference laboratory perspective

Dervla T.D. Kenna*, Zoë Payne, David A. Lee, Ann Marie Keane, Jack Turton, Dania V. Zamarreño, Ulf Schaefer, Katie L. Hopkins, Danièle Meunier, Rishi Dhillon, Jamie Duckers, Lorraine Speight, Jane F. Turton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We aimed to describe the UK Pseudomonas aeruginosa population structure amongst people with cystic fibrosis (PWCF), and to examine evidence for cross-infection. Methods: Variable Number Tandem Repeat (VNTR) typing was performed on 4640 isolates from 2619 PWCF received from 55 hospital laboratories between 2017 and 2019. A combination of whole genome sequence (WGS)-based analysis of four clusters from one hospital, and epidemiological analysis of shared strains in twelve hospitals evaluated cross-infection. Results: Of 2619 PWCF, 1324 (51%) harboured common clusters or known transmissible strains, while 1295 carried unique strains/those shared among small numbers of patients. Of the former, 9.5% (250 patients) harboured the Liverpool epidemic strain (LES), followed in prevalence by clone C (7.8%; 205 patients), cluster A (5%;130 patients), and cluster D (3.6%; 94 patients). WGS analysis of 10 LES isolates, 9 of cluster D and 6 isolates each of cluster A and clone C from one hospital revealed LES formed the tightest cluster (between 7 and 205 SNPs), and cluster D the loosest (between 53 and 1531 SNPs). Hospital-specific shared strains were found in some centres, although cross-infection was largely historical, with few new acquisitions. Fifty-nine PWCF (2.3%) harboured “high-risk” clones; one ST235 isolate carried a blaIMP-1 allele. Conclusion: Of 2619 PWCF who had P. aeruginosa isolates submitted for VNTR, 51% harboured either common clusters or known transmissible strains, of which LES was the most common. Limited evidence of recent patient-to-patient strain transmission was found, suggesting cross-infection prevention measures and surveillance effectively reduce transmission.

Original languageEnglish
Pages (from-to)894-900
Number of pages7
JournalJournal of Cystic Fibrosis
Volume22
Issue number5
DOIs
Publication statusPublished - Sept 2023

Bibliographical note

Publisher Copyright:
© 2023

Keywords

  • Cross-infection
  • Cystic fibrosis
  • Liverpool epidemic strain
  • Pseudomonas aeruginosa
  • Whole genome sequencing

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