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Abstract：
Guadeloupe (French West Indies), a Caribbean island, is an ideal place to study the reservoirs of the Klebsiella pneumoniae species complex (KpSC) and identify the routes of transmission between human and nonhuman sources due to its insularity, small population size, and small area. Here, we report an analysis of 590 biological samples, 546 KpSC isolates, and 331 genome sequences collected between January 2018 and May 2019. The KpSC appears to be common whatever the source. Extended-spectrum-β-lactamase (ESBL)-producing isolates (21.4%) belonged to K. pneumoniae sensu stricto (phylogroup Kp1), and all but one were recovered from the hospital setting. The distribution of species and phylogroups across the different niches was clearly nonrandom, with a distinct separation of Kp1 and Klebsiella variicola (Kp3). The most frequent sequence types (STs) (≥5 isolates) were previously recognized as high-risk multidrug-resistant (MDR) clones, namely, ST17, ST307, ST11, ST147, ST152, and ST45. Only 8 out of the 63 STs (12.7%) associated with human isolates were also found in nonhuman sources. A total of 22 KpSC isolates were defined as hypervirulent: 15 associated with human infections (9.8% of all human isolates), 4 (8.9%) associated with dogs, and 3 (15%) associated with pigs. Most of the human isolates (33.3%) belonged to the globally successful sublineage CG23-I. ST86 was the only clone shared by a human and a nonhuman (dog) source. Our work shows the limited transmission of KpSC isolates between human and nonhuman sources and points to the hospital setting as a cornerstone of the spread of MDR clones and antibiotic resistance genes. IMPORTANCE In this study, we characterized the presence and genomic features of isolates of the Klebsiella pneumoniae species complex (KpSC) from human and nonhuman sources in Guadeloupe (French West Indies) in order to identify the reservoirs and routes of transmission. This is the first study in an island environment, an ideal setting that limits the contribution of external imports. Our data showed the limited transmission of KpSC isolates between the different compartments. In contrast, we identified the hospital setting as the epicenter of antibiotic resistance due to the nosocomial spread of successful multidrug-resistant (MDR) K. pneumoniae clones and antibiotic resistance genes. Ecological barriers and/or limited exposure may restrict spread from the hospital setting to other reservoirs and vice versa. These results highlight the need for control strategies focused on health care centers, using genomic surveillance to limit the spread, particularly of high-risk clones, of this important group of MDR pathogens.
摘要：
瓜德罗普岛（法属西印度群岛），一个加勒比岛,是研究肺炎克雷伯菌物种复合体（KpSC）的水库并确定人类和非人类来源之间的传播途径的理想场所，人口规模小，面积小。这里,我们报告了590个生物样本的分析，546个KpSC分离株，和在2018年1月至2019年5月之间收集的331个基因组序列。无论来源如何，KpSC似乎都很常见。产超广谱β-内酰胺酶（ESBL）的分离株（21.4％）属于肺炎克雷伯菌（系统组Kp1），除了一个人之外，所有的人都从医院康复了。不同生态位的物种和系统群的分布显然是非随机的，具有明显的Kp1和花色克雷伯菌（Kp3）分离。最常见的序列类型（STs）（≥5个分离株）以前被认为是高风险的多药耐药（MDR）克隆。即,ST17、ST307、ST11、ST147、ST152和ST45。与人类分离株相关的63种STs中只有8种（12.7％）也在非人类来源中发现。共有22个KpSC分离株被定义为高毒力：15个与人类感染相关（占所有人类分离株的9.8％），4（8.9％）与狗有关，3（15%）与猪有关。大多数人类分离株（33.3％）属于全球成功的CG23-I亚谱系。ST86是人类和非人类（狗）来源共享的唯一克隆。我们的工作表明，KpSC分离株在人类和非人类来源之间的传播有限，并指出医院环境是MDR克隆和抗生素抗性基因传播的基石。在这项研究中的重要性，我们对瓜德罗普岛(法属西印度群岛)的人类和非人类来源的肺炎克雷伯菌复合体(KpSC)分离株的存在和基因组特征进行了表征,以确定其储库和传播途径.这是在岛屿环境中的第一项研究，限制外部进口贡献的理想环境。我们的数据显示KpSC分离株在不同区室之间的传播有限。相比之下,由于成功的多重耐药(MDR)肺炎克雷伯菌克隆和抗生素耐药基因在医院内传播,我们将医院环境确定为抗生素耐药的中心.生态屏障和/或有限的暴露可能会限制从医院环境到其他水库的传播，反之亦然。这些结果突出了针对医疗保健中心的控制策略的必要性，利用基因组监测来限制传播，特别是高风险克隆，这一组重要的MDR病原体。
