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For example, whole genome sequencing was used to study a hospital outbreak of multidrug-resistant Acinetobacter baumannii in England combining WGS information with classical epidemiological data.By these means, the transmission events were reconstructed and adequate measure for hospital infection control improved.The combination of phylogenetic and evolutionary analyses, based on genome-wide SNPs, with clinical and epidemiological data represents a powerful tool to infer the origin and the spread of K. Isolates temporally and spatial related could clarify the epidemiological transmission as so as the eventual reservoir in the hospital setting supporting the epidemiological surveillance and infections control strategies. pneumoniae KPC strains circulating within different wards of the University Hospital Campus Bio-Medico were collected and WGS applied.Classical epidemiological and Bayesian phylogenetic analysis were combined to evaluate transmission dynamics and evolutionary history of K.Carbapenems resistant Enterobacteriaceae (CRE) infections are increasing worldwide.In Italy, sporadic cases or outbreaks caused by CRE have been reported since the early 2000s.

Klebsiella pneumoniae MDR and KPC strains included in the study were isolated from 21 patients distributed in different wards of the hospital as in Fig. Isolates were collected more frequently from patients admitted in the general surgery and geriatric wards (Fig. The epidemic curve based on the number of isolates collected during the study period (Fig. pneumoniae MDR and KPC isolated in relationship with the ward and the length of stay in each ward.The white color correspond to the “zero” value indicating absence of over/under gene expression.Annotations were confirmed using Prokka, the type of genes annotated are reported in Table S2.Among patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), patients have investigated infections by KPC K.pneumoniae and endoscope isolates comparison using WGS.

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AST profile have been reported in the Supplementary Table S1.