Tracking a hospital outbreak of KPC-producing ST11 Klebsiella pneumoniae with whole genome sequencing Y. Jiang, Z. Wei, Y. Wang, X. Hua, Y. Feng, Y.

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Tracking a hospital outbreak of KPC-producing ST11 Klebsiella pneumoniae with whole genome sequencing Y. Jiang, Z. Wei, Y. Wang, X. Hua, Y. Feng, Y. Yu Clinical Microbiology and Infection Volume 21, Issue 11, Pages 1001-1007 (November 2015) DOI: 10.1016/j.cmi.2015.07.001 Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 1 (a) The single-nucleotide polymorphisms (SNPs) numbers between each blaKPC-producing strain. The gradient of blue intensity illustrates the quantity scale of SNPs. (b) A maximum-likelihood phylogenetic tree was constructed, and the 12 outbreak strains were divided into three clades. Clinical Microbiology and Infection 2015 21, 1001-1007DOI: (10.1016/j.cmi.2015.07.001) Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 2 Pulsed-field gel electrophoresis profiles of S1 nuclease-digested total DNA from 12 blaKPC-producing Klebsiella pneumoniae strains. Strains K15, K22-1, K22-2, K28-1, K28-2, K45, K47, K48, K49 and K50 harboured a plasmid of approximately 145 kb that contained resistance genes, including blaKPC-2, blaCTX-M-65, blaTEM-1B, rmtB, aadA2, sul1, and fosA3. Strains K6 and K11 harboured a plasmid of approximately 170 kb that contained an additional catA2 gene in addition to those resistance genes found in the 145-kb plasmid. Additionally, strain K11 harboured a plasmid of approximately 90 kb that contained aac(6′)-Ib-cr and blaOXA-1. M, marker. Clinical Microbiology and Infection 2015 21, 1001-1007DOI: (10.1016/j.cmi.2015.07.001) Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 3 Timelines of the infectious patients harbouring blaKPC-producing strains staying in the hospital. The olive green rectangle represents the department of neurosurgery, the light blue rectangle represents the intensive-care unit (ICU), the dark blue rectangle represents the emergency ICU, and the dark violet rectangle represents the department of general surgery. Red triangles indicate sampling dates. Some patients overlapped in their hospital stay units or time frames. Clinical Microbiology and Infection 2015 21, 1001-1007DOI: (10.1016/j.cmi.2015.07.001) Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. S1 Pulsed-field gel electrophoresis (PFGE) pattern analysis for all 66 Klebsiella pneumoniae strains. Pattern similarities were evaluated according to the different band numbers. M, marker. Clinical Microbiology and Infection 2015 21, 1001-1007DOI: (10.1016/j.cmi.2015.07.001) Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions