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We evaluated CRKp clustering in patients in US hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From April 2016 to August 2017, 350 patients with clonal group 258 CRKp were enrolled in the Consortium on Resistance Against Carbapenems in Klebsiella and other Enterobacteriaceae, a prospective, multicenter, cohort study. A maximum likelihood tree was constructed using RAxML. Static clusters shared \u226421 single-nucleotide polymorphisms (SNP) and a most recent common ancestor. Dynamic clusters incorporated SNP distance, culture timing, and rates of SNP accumulation and transmission using the R program TransCluster.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most patients were admitted from home (n = 150, 43%) or long-term care facilities (n = 115, 33%). Urine (n = 149, 43%) was the most common isolation site. Overall, 55 static and 47 dynamics clusters were identified involving 210 of 350 (60%) and 194 of 350 (55%) patients, respectively. Approximately half of static clusters were identical to dynamic clusters. Static clusters consisted of 33 (60%) intrasystem and 22 (40%) intersystem clusters. Dynamic clusters consisted of 32 (68%) intrasystem and 15 (32%) intersystem clusters and had fewer SNP differences than static clusters (8 vs 9; P = .045; 95% confidence interval [CI]: \u22124 to 0). Dynamic intersystem clusters contained more patients than dynamic intrasystem clusters (median [interquartile range], 4 [2, 7] vs 2 [2, 2]; P = .007; 95% CI: \u22123 to 0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Widespread intrasystem and intersystem transmission of CRKp was identified in hospitalized US patients. Use of different methods for assessing genetic similarity resulted in only minor differences in interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac791","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T13:54:13Z","timestamp":1664459653000},"page":"229-237","source":"Crossref","is-referenced-by-count":37,"title":["Transmission of Carbapenem-Resistant\n                    <i>Klebsiella pneumoniae<\/i>\n                    in US Hospitals"],"prefix":"10.1093","volume":"76","author":[{"given":"Courtney L","family":"Luterbach","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of North Carolina , Chapel Hill, North Carolina , USA"},{"name":"Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina , Chapel Hill, North Carolina , 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebbing","family":"Lautenbach","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn","family":"Wortmann","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, MedStar Washington Hospital Center , Washington, District of Columbia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C","family":"Kalayjian","sequence":"additional","affiliation":[{"name":"Department of Medicine, MetroHealth Medical Center , Cleveland, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Eilertson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, State University of New York Downstate , Brooklyn, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"Farrell","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine, OSF Saint Francis Medical Center, University of Illinois College of Medicine at Peoria , Peoria, Illinois , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"McCarty","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, University of Alabama at Birmingham , Birmingham, Alabama , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Hill","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Vance G","family":"Fowler","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke 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