Genomic analysis of K. pneumoniae collected from patients in neonatal intensive care unit in Patan hospital, Nepal

Multidrug resistant K. pneumoniae is one of the most seriously pathogen because of its ability to against wide range of available antibiotics, leading to various limitations in treatment, especially in low-income settings. Patan hospital in Nepal, where had previously reported multiple outbreaks causing by MDR K. pneumonia in neonatal intensive care unit (NICU) with significant mortality rate up to 75%, has recently burdened an outbreak by the same strains. In this study, using the state-of-the-art methods, we aim to define recent outbreak and further to investigate the genetically correlation between these outbreaks. Here we describe the re-emergence of an outbreak in 2015 in Patan hospital from the end of 2014 by the same specific MDR K. pneumoniae as previous ones, sequence type 15 (ST15). Albeit similar and multidrug resistant, these strains have shown susceptible for carbapenems since blaNDM-1 gene cassette had gone away. Besides, they also carried four different plasmids harbored a huge range of antimicrobial resistant genes assisting them to be more survival to infected humans. Particular insights into the cause of 2015 outbreak as well as genetic traits will considerably contribute to heighten public awareness and the hospital implement improved healthy strategies