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Int J Infect Dis ; 17(9): e714-7, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23528638

RESUMEN

OBJECTIVE: The identification of patients colonized or infected with carbapenemase-producing Enterobacteriaceae (CPE), in order to control and prevent the global spread of multidrug-resistant (MDR) pathogens. METHODS: From June 1 to June 15, 2012, eight Citrobacter freundii strains with reduced susceptibility to carbapenems were isolated from rectal swabs of hospitalized patients during active screening following the detection of a Klebsiella pneumoniae carbapenemase (KPC) -positive patient on the ward. All isolates were analyzed phenotypically and molecularly by PCR and sequencing. Genotype clustering was performed by multilocus sequence typing (MLST) analysis. RESULTS: The isolates showed high rates of multidrug resistance profile. A phenotypic assay for carbapenemase production suggested the presence of metallo-ß-lactamase (MBL). The blaVIM-1 gene was detected in all imipenem-resistant C. freundii isolates. MLST showed that the C. freundii isolates shared the same sequence type (ST). Phylogenetic analysis revealed a strict relationship with an ST5C. freundii isolate from a diarrhea patient in China. CONCLUSIONS: Our findings showed that the active surveillance program for CPE was useful, not only for the detection of KPC-producers, but also to identify and control the spread of other MDR pathogens that could expand the spectrum of circulating MDR pathogens.


Asunto(s)
Citrobacter freundii/genética , Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Infecciones por Enterobacteriaceae/epidemiología , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Citrobacter freundii/clasificación , Citrobacter freundii/efectos de los fármacos , Infección Hospitalaria/microbiología , Infecciones por Enterobacteriaceae/microbiología , Femenino , Hospitales , Humanos , Italia/epidemiología , Masculino , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Filogenia , beta-Lactamasas/genética
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