{"doi":"10.1016/j.ijid.2024.02.014","title":"Real-time genomic epidemiologic investigation of a multispecies plasmid-associated hospital outbreak of NDM-5-producing Enterobacterales infections","abstract":"OBJECTIVES: resistance gene is often carried on plasmids, traditional infection prevention and control (IP&C) surveillance methods and reactive whole genome sequencing (WGS) may not detect plasmid transfer in multispecies outbreaks. METHODS: Initial outbreak detection of NDM-producing Enterobacterales identified at an acute care hospital occurred via traditional IP&C methods and was supplemented by real-time WGS surveillance performed weekly. To resolve NDM-encoding plasmids, we performed long-read sequencing and constructed hybrid assemblies. WGS data for suspected outbreaks was shared with the IP&C team for assessment and intervention. RESULTS: We observed a multispecies outbreak of NDM-5-producing Enterobacterales isolated from 15 patients between February 2021 and February 2023. The 19 clinical and surveillance isolates sequenced included 7 bacterial species encoding the same NDM-5 plasmid. WGS surveillance and epidemiologic investigation characterized 10 horizontal plasmid transfer events and 6 bacterial transmission events between patients in varying hospital units. CONCLUSIONS: Our investigation revealed a complex, multispecies outbreak of NDM involving multiple plasmid transfer and bacterial transmission events. We highlight the utility of combining traditional IP&C and prospective genomic methods in identifying and containing plasmid-associated outbreaks.","journal":"International Journal of Infectious Diseases","year":2024,"id":424497,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9451,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1173112,"name":"Abby L. Valek","orcid":null,"position":1,"is_corresponding":false},{"id":356082,"name":"M. Patrick Griffith","orcid":"0000-0003-1012-881X","position":2,"is_corresponding":false},{"id":859596,"name":"Emma G. Mills","orcid":null,"position":3,"is_corresponding":false},{"id":356084,"name":"Kady Waggle","orcid":"0009-0001-9237-9964","position":4,"is_corresponding":false},{"id":356085,"name":"Vatsala Rangachar Srinivasa","orcid":"0000-0001-7376-8764","position":5,"is_corresponding":false},{"id":356087,"name":"Ashley Ayres","orcid":"0000-0001-8476-9770","position":6,"is_corresponding":false},{"id":1173113,"name":"Claire M. Bradford","orcid":null,"position":7,"is_corresponding":false},{"id":1172789,"name":"Hannah M. Creager","orcid":"0000-0003-0924-4717","position":8,"is_corresponding":false},{"id":1046650,"name":"Lora Pless","orcid":"0000-0003-0163-3689","position":9,"is_corresponding":false},{"id":334726,"name":"Alexander Sundermann","orcid":"0000-0002-2439-6287","position":10,"is_corresponding":false},{"id":302051,"name":"Daria Van Tyne","orcid":"0000-0001-7284-0103","position":11,"is_corresponding":false},{"id":334728,"name":"Graham M. Snyder","orcid":"0000-0001-5562-8880","position":12,"is_corresponding":false},{"id":281657,"name":"Lee H. Harrison","orcid":"0000-0002-3787-2705","position":13,"is_corresponding":false},{"id":1172788,"name":"Nathan J. Raabe","orcid":"0000-0002-3258-9003","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T01:58:21.523756Z","pmid":"38373647","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}