6533b85bfe1ef96bd12ba19f
RESEARCH PRODUCT
Ongoing spread of colistin-resistant Klebsiella pneumoniae in different wards of an acute general hospital, Italy, June to December 2011.
Daniela Maria PalmaCaterina MamminaMaria Antonietta SaporitoAurora AleoConcetta SodanoF. Di BernardoTeresa FascianaRomano TetamoCelestino BonuraMaria Stella Verdesubject
DNA BacterialSettore MED/07 - Microbiologia E Microbiologia ClinicaEpidemiologyKlebsiella pneumoniaeMicrobial Sensitivity TestsSettore MED/42 - Igiene Generale E ApplicataHospitals GeneralPolymerase Chain ReactionKlebsiella pneumoniae carbapenems colistin resistance ICU epidemiologybeta-LactamasesMicrobiologyDisease OutbreaksAntibiotic resistanceVirologyIntensive careDrug Resistance Multiple BacterialPatients' RoomsMedicineHumansKlebsiella pneumoniae; colistin-resistance; MLSTGeneral hospitalCross Infectionbiologybusiness.industryColistinPublic Health Environmental and Occupational HealthOutbreakbiochemical phenomena metabolism and nutritionbiology.organism_classificationAnti-Bacterial AgentsBacterial Typing TechniquesKlebsiella InfectionsIntensive Care UnitsKlebsiella pneumoniaeCarbapenemsItalyColistinMultilocus sequence typingbusinessHorizontal transmissionmedicine.drugMultilocus Sequence Typingdescription
We describe polyclonal spread of colistin-resistant Klebsiella pneumoniae in an acute general hospital in Italy. Between June and December 2011, 58 colistin-resistant K. pneumoniae isolates were recovered from 28 patients admitted to different wards, but mainly in the intensive care units. All isolates were tested for drug susceptibility and the presence of beta-lactamase (bla) genes. Clonality was investigated by repetitive extragenic palindromic (rep)-PCR and multilocus sequence typing (MLST). Fifty-two isolates had minimum inhibitory concentrations (MICs) for colistin of 6-128 mg/L, carried blaKPC3 and were attributed to sequence type ST258. The remaining six isolates were susceptible to carbapenems, exhibited MICs for colistin of 3-32 mg/L, and belonged to two different types, ST15 and ST273. Rep-PCR included all isolates in three clusters, one containing all ST258 KPC-3-producing isolates and two containing ST15 and ST273 isolates. Cross-transmission containment measures and intensification of staff and environmental hygiene could not stop the outbreak. Selective pressure and horizontal transmission probably contributed to emergence and spread of three different strains of colistin-resistant K. pneumoniae in the hospital. Strict implementation of the above measures and a wider awareness of the antimicrobial resistance threat are crucial to preserve the last therapeutic options of the multidrug-resistant Gram-negative infections. .
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2012-08-16 | Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin |