Rectal Carriage of Sequence Type 307 <i>Klebsiella pneumoniae</i> High‐Risk Clone Harboring Multiple Carbapenemase Genes in Community Hospitals Gauteng, South Africa
Bibliographic record
Abstract
ABSTRACT Asymptomatic rectal carriers are recognized as reservoirs of carbapenem‐resistant Klebsiella pneumoniae (CRKp), which can spread epidemic high‐risk clones [e.g., sequence types (ST)‐307] and plasmids [incompatibility group (Inc)‐X3] in hospitals, with possible transmission into the community. This study investigated the epidemiology and characteristics of CRKp high‐risk clones ST307 among rectal carriage isolates from community hospitals. A carbapenemase positivity rate of 24% was observed for all rectal screening performed during hospital admission (February to August 2021) in Gauteng, South Africa; 252 CRKp isolates were characterized. Antimicrobial susceptibility was performed using the VITEK 2 automated system, and polymerase chain reaction assays were used to detect K. pneumoniae ST307, carbapenemase genes, and associated mobile genetic elements (MGEs e.g., IncX3, IS3000). Of the 252 isolates, 25% (64/252) were ST307 positive and 75% (188/252) were non‐ST307. Among the 64 ST307, 45% (29/64) harbored bla OXA‐181 on IncX3 plasmids. Occurrence of bla OXA‐181 among ST307 (69%; 44/64) when compared to non‐ST307 (48%; 91/188) was statistically significant ( p ‐value = 0.002). Fourteen isolates, including two ST307, harbored double carbapenemase genes. Carbapenemase gene combinations include six bla NDM +bla OXA‐48‐like , four bla NDM +bla OXA‐181 , three bla KPC +bla OXA‐181 , and one bla OXA‐181 + bla VIM . One ST307 isolate harbored three carbapenemase genes ( bla NDM +bla OXA‐48 +bla OXA‐181 ). Level of antimicrobial resistance was significantly ( p ‐value < 0.001) associated with the occurrence of ST307, comprising 73% (47/64) extensively drug resistant. This study highlights the need for rectal screening of XDR clones and plasmids using simple and cost‐effective genomic methodologies suitable for low‐ and middle‐income countries for local risk management and control of infectious diseases in hospitals.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".