Nosocomial outbreak of genetically related IMP-1 β-lactamase-producing Klebsiella pneumoniae in a general hospital in Japan

Fukigai, Shinako; Alba, Jimena; Kimura, Soichiro; Iida, Toshie; Nishikura, Noriko; Ishii, Yoshikazu; Yamaguchi, Keizo

doi:10.1016/j.ijantimicag.2006.10.011

Cited by 51 publications

(46 citation statements)

References 25 publications

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“…CPE have the ability to transfer their resistance genes to other pathogens in the hospital environment as well as to cause large mono-or multiclonal hospital outbreaks (11,12,30,32,35). Thus, the control of these pathogens is imperative and clinical laboratories are facing the challenge of screening surveillance specimens for CPE.…”

Section: Discussionmentioning

confidence: 99%

“…These isolates produce different types of ␤-lactamases capable of hydrolyzing carbapenems. Among these carbapenemases, metallo-␤-lactamases (MBLs; Ambler class B) and Klebsiella pneumoniae carbapenemase (KPC; Ambler class A) are prevailing in Enterobacteriaceae from countries or large geographic regions, including the United States, Israel, Italy, Greece, the Far East, and South America (9,12,14,15,17,18,22,26,27). Moreover, oxacillinase-48 (OXA-48; Ambler class D) has recently been isolated in Enterobacteriaceae from Turkey (6), and it has since been reported from other countries in the Mediterranean Basin and Western Europe (13,22).…”

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confidence: 99%

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Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

et al. 2012

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c Carbapenemase-producing Enterobacteriaceae (CPE) are an increasing problem worldwide, and rectal swab surveillance is recommended as a component of infection control programs. The performance of a prototype chromogenic medium (chromID CARBA) was evaluated and compared with media tested by four other screening methods: (i) overnight selective enrichment in 5 ml tryptic soy broth with a 10-g ertapenem disk followed by plating onto MacConkey agar (CDC-TS), (ii) short selective enrichment in 9 ml brain heart infusion broth with a 10-g ertapenem disk followed by plating onto chromID ESBL medium (ESBL-BH), (iii) direct plating onto chromID ESBL, and (iv) direct plating onto MacConkey agar supplemented with meropenem (1 g/ml) (MCM). The screening methods were applied to detect CPE in 200 rectal swab specimens taken from different hospitalized patients. Identification and antimicrobial susceptibility were performed by the Vitek 2 system. Carbapenem MICs were checked by Etest. Carbapenemase production was confirmed using the modified Hodge test, combined-disk tests, and PCR assays. In total, 133 presumptive CPE strains were detected. Phenotypic and genotypic assays confirmed 92 strains to be CPE (56 KPC-positive Klebsiella pneumoniae, 29 VIM-positive K. pneumoniae, and 7 KPC-positive Enterobacter aerogenes strains) recovered from 73 patients, while the remaining 41 strains were confirmed to be CPE negative (19 ESBL producers and 22 nonfermenters). chromID CARBA, ESBL-BH, and chromID ESBL exhibited the highest sensitivity (92.4%), followed by CDC-TS and MCM (89.1%) (P ‫؍‬ 0.631). The specificity was greater for chromID CARBA (96.9%) and ESBL-BH (93.2%) than for CDC-TS (86.4%), MCM (85.2%), and chromID ESBL (84.7%) (P ‫؍‬ 0.014). In conclusion, chromID CARBA was found to be a rapid and accurate culture screening method for active CPE surveillance.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

et al. 2012

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“…Since then, KPC-producing K. pneumoniae strains have been spreading worldwide. Additional carbapenemases (bla NDM , bla , bla VIM , and bla IMP-1 ) have now been reported for MDR Enterobacteriaceae, including K. pneumoniae (5)(6)(7)(8). A last-resort treatment for infections caused by MDR Gram-negative bacteria is represented by membrane-acting polymyxins such as colistin, but resistance to this antibiotic in K. pneumoniae is also emerging (9,10).…”

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confidence: 99%

Tracking Nosocomial Klebsiella pneumoniae Infections and Outbreaks by Whole-Genome Analysis: Small-Scale Italian Scenario within a Single Hospital

et al. 2015

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f Multidrug-resistant (MDR) Klebsiella pneumoniae is one of the most important causes of nosocomial infections worldwide. After the spread of strains resistant to beta-lactams at the end of the previous century, the diffusion of isolates resistant to carbapenems and colistin is now reducing treatment options and the containment of infections. Carbapenem-resistant K. pneumoniae strains have spread rapidly among Italian hospitals, with four subclades of pandemic clonal group 258 (CG258). Here we show that a single Italian hospital has been invaded by three of these subclades within 27 months, thus replicating on a small scale the "Italian scenario." We identified a single clone responsible for an epidemic outbreak involving seven patients, and we reconstructed its star-like pattern of diffusion within the intensive care unit. This epidemiological picture was obtained through phylogenomic analysis of 16 carbapenem-resistant K. pneumoniae isolates collected in the hospital during a 27-month period, which were added to a database of 319 genomes representing the available global diversity of K. pneumoniae strains. Phenotypic and molecular assays did not reveal virulence or resistance determinants specific for the outbreak isolates. Other factors, rather than selective advantages, might have caused the outbreak. Finally, analyses allowed us to identify a major subclade of CG258 composed of strains bearing the yersiniabactin virulence factor. Our work demonstrates how the use of combined phenotypic, molecular, and whole-genome sequencing techniques can help to identify quickly and to characterize accurately the spread of MDR pathogens.

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“…Strict hygiene practices and careful use of antibiotics are critical to prevent spreading of VIM positive K. pneumoniae isolates. Reduction in antibiotic consumption is clearly important to minimize the antimicrobial resistance in Gram negative bacilli (6,15).…”

Section: Case Reportmentioning

confidence: 99%

“…IMP and VIM enyzmes are the most prevalent types in acquired MBL and they have appeared globally. VIM producing Klebsiella pneumoniae isolates have been established in Europe, mostly in Greece and Italy (5,6). In Turkey, VIM producing Klebsiella pneumoniae isolates are usually sporadic cases and no outbreak has been reported yet.…”

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confidence: 99%

Bacteremia due to A VIM-1 producing klebsiella pneumoniae ısolate from an acute lymphoblastic leukemia patient ın Antalya

2014

J Turgut Ozal Med Cent

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A Klebsiella pneumoniae clinical isolate resistant to imipenem was recovered from blood culture of a 4 years old child with the diagnosis of acute precursor B cell lymphoblastic leukemia. PCR assays of Klebsiella pneumoniae isolate were positive with blaCTX-M and blaVIM genes.Sequence analysis of the 160 bp amplicon matched with blaVIM 1. Patient was discharged on the 15th day of ciprofloxacin theraphy with remission. We report here the first VIM-1 positive Klebsiella pneumoniae isolate case from Akdeniz University Hospital. Urgent and rapid precautions must be preferred including antibiotic policy and infection control practices when the first case with different resistance patern is detected.

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Nosocomial outbreak of genetically related IMP-1 β-lactamase-producing Klebsiella pneumoniae in a general hospital in Japan

Cited by 51 publications

References 25 publications

Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

Tracking Nosocomial Klebsiella pneumoniae Infections and Outbreaks by Whole-Genome Analysis: Small-Scale Italian Scenario within a Single Hospital

Bacteremia due to A VIM-1 producing klebsiella pneumoniae ısolate from an acute lymphoblastic leukemia patient ın Antalya

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