2013
DOI: 10.1590/s0074-02762013000100019
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Outbreak of carbapenem-resistant Klebsiella pneumoniae: two-year epidemiologic follow-up in a tertiary hospital

Abstract: This study describes a carbapenem-resistant Klebsiella pneumoniae (CRKP) outbreak that occurred from October 2008-December 2010. Polymerase chain reaction assays were performed to detect the bla KPC gene and molecular typing was performed using pulsed-field gel electrophoresis (PFGE) The emergence of strains of multidrug-resistant Klebsiella pneumoniae has been reported with increasing frequency in several countries worldwide. Carbapenem-resistant K. pneumoniae (CRKP) can cause nosocomial infections and outbre… Show more

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Cited by 18 publications
(12 citation statements)
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References 14 publications
(13 reference statements)
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“…Studies conducted in Spain, from 2010 to 2014, indicate resistance to imipenem 1.7%, ciprofloxacin 20.1%, gentamicin 10.4% and amikacin 1.9%, which is significantly lower than in our study [22]. When we compare the results of our study with available data from the National Reference Laboratory, we can notice a slight increase in resistance to amixocillin/clavulanic acid from 92.8% in 2013. to 100% in 2014 in our study [23].…”
Section: Discussionsupporting
confidence: 48%
See 1 more Smart Citation
“…Studies conducted in Spain, from 2010 to 2014, indicate resistance to imipenem 1.7%, ciprofloxacin 20.1%, gentamicin 10.4% and amikacin 1.9%, which is significantly lower than in our study [22]. When we compare the results of our study with available data from the National Reference Laboratory, we can notice a slight increase in resistance to amixocillin/clavulanic acid from 92.8% in 2013. to 100% in 2014 in our study [23].…”
Section: Discussionsupporting
confidence: 48%
“…The study conducted at the Clinic of Infectious Diseases of the CCV in the period from 2012 to 2014, showed no resistance to Klebsiella pneumoniae to carbapenems, except for one isolate in 2013 that was resistant [16]. In this study, resistance to trimethopime/ sulfamethoxazole, a drug that has been widely used in general practice in urinary infections, is about 50%, while data from Korea indicate a significantly lower percentage of resistance to this antibiotic (18%) [23]. The high percentage of resistance to trimethoprim/ sulfamethoxazole is most likely due to a large use of this drug in the treatment of urinary infections.…”
Section: Discussionmentioning
confidence: 62%
“…Although polymixins were reintroduced in clinical practice a few years ago to combat multi-resistant Gram-negative bacilli, they have shown a slow and progressive reduction in activity against carbapenemase-producing K. pneumoniae, which in some studies has reached resistance rates that exceed 20% (25) (26) . Hetero-resistance to colistin, which is used more extensively, as well as the long-term therapy with polymixins are factors favoring the selection of strains resistant to these drugs (27) .…”
Section: Ethical Considerationsmentioning
confidence: 99%
“…Polymyxin B and colistin (polymyxin E) are now one of the last viable therapeutic options [ 3 ]. Unfortunately, resistance to this last-line antibiotic class is an increasing global burden, with countries particularly impacted including Asia (South Korea [ 4, 5 ], India [ 6, 7 ]), Europe (Greece [ 8–10 ]), Italy [ 10, 11 ]) and Latin America (Brazil [ 12, 13 ]). Mortality is influenced by polymyxin resistance typically occurring on a multidrug-resistant (MDR) or XDR background; nephrotoxicity leads to suboptimal dosing as well as inadequacies in detection of heteroresistance [ 10, 14 ].…”
Section: Introductionmentioning
confidence: 99%