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Peer-reviewedCC BY 4.0Antimicrobial Agents and Chemotherapy

Emergence and local dissemination of NDM-14-producing Klebsiella pneumoniae ST147: a phylodynamic and epidemiological investigation

  • Gabriele Arcari1,2
  • Mattia Carbotti2
  • Riccardo Pavesi2
  • Paolo Gigante2
  • Riccardo Capuano2
  • Domenico Caleca2
  • Angelo Paolo Genoni1,2
  • Stefano Gaiarsa3
  • Gherard Batisti Biffignandi3,4
  • Angela Kuka3
  • Federica Novazzi1,2
  • Fausto Baldanti3,5
1 more authors
  • Nicasio Mancini1,2
5 affiliations
  1. 1Laboratory of Medical Microbiology and Virology, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
  2. 2Laboratory of Medical Microbiology and Virology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
  3. 3Microbiology and Virology Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
  4. 4Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
  5. 5Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
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Abstract

NDM-14-producing Klebsiella pneumoniae ST147 has recently emerged as a high-risk clone in Europe, but its local dissemination dynamics remain poorly defined. We investigated a 6-month outbreak across three hospitals within a regional healthcare network in Lombardy, Northern Italy. Among 32 NDM-producing K. pneumoniae, isolated between December 2024 and May 2025, 19 belonged to ST147, including one NDM-1 producer and 18 carrying NDM-14 or its A233V variant NDM-61. Phylodynamic analysis of the ST147 NDM-14/NDM-61 genomes showed they were closely related (8–91 core SNPs) and descended from a most recent common ancestor dated to June 2024 (95% highest posterior density interval, 6 months). Reconstruction of the transmission network hints at the presence of at least three transmission clusters within the healthcare system: a major chain involving 11 of 18 cases spanning wards and facilities, a separate pair of linked cases, and 5 epidemiologically unlinked cases, suggesting missed intermediates or secondary introductions. The spread was characterized by rapid local expansion of the clone across intensive care, medical, and rehabilitation. These findings underscore the propensity of NDM-14-producing ST147 to disseminate efficiently within interconnected hospitals and highlight the need for enhanced genomic surveillance, coordinated infection control strategies, and judicious use of last-resort agents in regional healthcare networks. In a global phylogenetic context, the Italian isolates clustered within a broader NDM-14 ST147 population composed of several geographically distinct clades associated with France, Italy, Spain, Morocco, and the United Kingdom.

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Cite

BibTeXRIS
BibTeX
@article{arcari2026emergence,
  title = {{Emergence and local dissemination of NDM-14-producing Klebsiella pneumoniae ST147: a phylodynamic and epidemiological investigation}},
  author = {Gabriele Arcari and Mattia Carbotti and Riccardo Pavesi and Paolo Gigante and Riccardo Capuano and Domenico Caleca and Angelo Paolo Genoni and Stefano Gaiarsa and Gherard Batisti Biffignandi and Angela Kuka and Federica Novazzi and Fausto Baldanti and Nicasio Mancini},
  journal = {Antimicrobial Agents and Chemotherapy},
  year = {2026},
  month = aug,
  doi = {10.1128/aac.00545-26},
  url = {https://doi.org/10.1128/aac.00545-26},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Emergence and local dissemination of NDM-14-producing Klebsiella pneumoniae ST147: a phylodynamic and epidemiological investigation
AU  - Gabriele Arcari
AU  - Mattia Carbotti
AU  - Riccardo Pavesi
AU  - Paolo Gigante
AU  - Riccardo Capuano
AU  - Domenico Caleca
AU  - Angelo Paolo Genoni
AU  - Stefano Gaiarsa
AU  - Gherard Batisti Biffignandi
AU  - Angela Kuka
AU  - Federica Novazzi
AU  - Fausto Baldanti
AU  - Nicasio Mancini
PY  - 2026
DA  - 2026/08/11
JO  - Antimicrobial Agents and Chemotherapy
DO  - 10.1128/aac.00545-26
UR  - https://doi.org/10.1128/aac.00545-26
AB  - NDM-14-producing Klebsiella pneumoniae ST147 has recently emerged as a high-risk clone in Europe, but its local dissemination dynamics remain poorly defined. We investigated a 6-month outbreak across three hospitals within a regional healthcare network in Lombardy, Northern Italy. Among 32 NDM-producing K. pneumoniae, isolated between December 2024 and May 2025, 19 belonged to ST147, including one NDM-1 producer and 18 carrying NDM-14 or its A233V variant NDM-61. Phylodynamic analysis of the ST147 NDM-14/NDM-61 genomes showed they were closely related (8–91 core SNPs) and descended from a most recent common ancestor dated to June 2024 (95% highest posterior density interval, 6 months). Reconstruction of the transmission network hints at the presence of at least three transmission clusters within the healthcare system: a major chain involving 11 of 18 cases spanning wards and facilities, a separate pair of linked cases, and 5 epidemiologically unlinked cases, suggesting missed intermediates or secondary introductions. The spread was characterized by rapid local expansion of the clone across intensive care, medical, and rehabilitation. These findings underscore the propensity of NDM-14-producing ST147 to disseminate efficiently within interconnected hospitals and highlight the need for enhanced genomic surveillance, coordinated infection control strategies, and judicious use of last-resort agents in regional healthcare networks. In a global phylogenetic context, the Italian isolates clustered within a broader NDM-14 ST147 population composed of several geographically distinct clades associated with France, Italy, Spain, Morocco, and the United Kingdom.
SN  - 0066-4804
SN  - 1098-6596
ER  -