Nosocomial outbreak of KPC-2- and NDM-1-producing Klebsiella pneumoniae in a neonatal ward: a retrospective study

BMC Infectious Diseases

Research Article

Yue Wang¹  Xuhui Zhu¹  Zhongju Chen¹  Jing Yu¹  Ziyong Sun¹  Kun Tan²  Li Tan²  Wei Xiong²  Ling Chen³  Zhihui Rong³  Li Wu³ 

[1] Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Jiefang Road 1095#, 430000, Wuhan, China;Department of Infection Control, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Jiefang Road 1095#, 430000, Wuhan, China;Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095#, 430000, Wuhan, China;

关键词: Multidrug-Resistant;    Klebsiella pneumoniae;    KPC-2;    NDM-1;    Nosocomial Infection;    Neonate;   

DOI  :  10.1186/s12879-016-1870-y

 received in 2016-06-14, accepted in 2016-09-27,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe spread of resistance to carbapenems among Enterobacteriaceae has become a major public health problem in recent years. In this study, we describe an outbreak of Klebsiella pneumoniae in the neonatal ward. First, we aimed to study the drug resistance, genetic relatedness, and transmission mechanism of carbapenem-resistant K. pneumoniae; second, we implemented infection control measures to contain the outbreak.MethodsWe investigated 27 non-repetitive strains isolated from neonates and five strains cultured from around the neonatal ward. Polymerase chain reaction (PCR), the agar dilution method, and multilocus sequence typing (MLST) were used to analyze the resistance gene(s), antimicrobial susceptibility, and homology, respectively. Health-care personnel education, hand hygiene, outer gown changing, and infected patient isolation were strictly enforced.ResultsOur antimicrobial susceptibility results show that all strains were multidrug-resistant. MLST and PCR results revealed that, in this study, all of the KPC-2-producing strains are Sequence Type (ST) 11 (ST11) (n = 22) and all of the NDM-1-producing strains are ST20 (n = 4) or ST888 (n = 1). The environmental strains were identified as KPC-2-positive K. pneumoniae ST11 (n = 3) and NDM-1-positive K. pneumoniae ST20 (n = 2). The percentages of isolates with the extended-spectrum-β-lactamases CTX-M-15, blaCTX-M-14, blaTEM-1 were 9.4, 84.3, and 68.8 %, respectively. AmpC β-lactamase genes were not detected in our isolates.ConclusionsKPC-2-positive K. pneumoniae ST11 and NDM-1-positive K. pneumoniae ST20 were associated with this outbreak. The identification of these isolates in samples from radiant warmers and nurses suggests that hospital cross-transmission played a role in this outbreak. Active infection control measures were effective for controlling this multidrug-resistant K. pneumoniae outbreak.

【 授权许可】

CC BY   
© The Author(s). 2016