title: Nosocomial Outbreak of Drug-Resistant Streptococcus pneumoniae Serotype 9V in an Adult Respiratory Medicine Ward.
abstract: Streptococcus pneumoniaeinfections arising in hospitalized patients are often assumed to be sporadic and linked to community acquisition. Here, whole-genome sequencing was used to demonstrate nosocomial acquisition of antimicrobial-resistant sequence type 156 (ST156) serotype 9VS. pneumoniaein 3 respiratory patients that resulted in two bacteremias and one lower respiratory tract infection. Two of the cases arose in patients who had recently been discharged from the hospital and were readmitted from the community. Nosocomial spread was suspected solely because of the highly unusual resistance pattern and case presentations within 24 h of one another. The outbreak highlights the potential for rapid transmission and the short incubation period in the respiratory ward setting.
authors.affiliation: Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, United Kingdom.|Department of Medicine, Imperial College London, London, United Kingdom.
authors.forename: Elita
authors.identifier: 0000-0002-7075-6896
authors.initials: E
authors.lastname: Jauneikaite
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Zareena
authors.initials: Z
authors.lastname: Khan-Orakzai
authors.affiliation: Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, National Infection Service, Colindale, London, United Kingdom.
authors.forename: Georgia
authors.initials: G
authors.lastname: Kapatai
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Susannah
authors.initials: S
authors.lastname: Bloch
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Julie
authors.initials: J
authors.lastname: Singleton
authors.affiliation: North West London Health Protection Team, Public Health England, London, United Kingdom.
authors.forename: Sara
authors.initials: S
authors.lastname: Atkin
authors.affiliation: North West London Health Protection Team, Public Health England, London, United Kingdom.
authors.forename: Victoria
authors.initials: V
authors.lastname: Shah
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Hatcher
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Dunisha
authors.initials: D
authors.lastname: Samarasinghe
authors.affiliation: Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, National Infection Service, Colindale, London, United Kingdom.
authors.forename: Carmen
authors.initials: C
authors.lastname: Sheppard
authors.affiliation: Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, National Infection Service, Colindale, London, United Kingdom.
authors.forename: Norman K
authors.identifier: 0000-0003-4862-6507
authors.initials: NK
authors.lastname: Fry
authors.affiliation: Imperial College Healthcare NHS Trust, London, United Kingdom giovanni.satta@imperial.nhs.uk s.sriskandan@imperial.ac.uk.|Centre for Clinical Microbiology, University College London, London, United Kingdom.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Satta
authors.affiliation: Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, United Kingdom giovanni.satta@imperial.nhs.uk s.sriskandan@imperial.ac.uk.|Department of Medicine, Imperial College London, London, United Kingdom.
authors.forename: Shiranee
authors.initials: S
authors.lastname: Sriskandan
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D005260:Female; D016680:Genome, Bacterial; D006748:Hospital Departments; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D011008:Pneumococcal Infections / Q000453:epidemiology*; D017422:Sequence Analysis, DNA; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*
keywords: Streptococcus pneumoniae; bacteremia; nosocomial infections; pneumonia; serotype 9V