Ongoing spread of colistin-resistant Klebsiella pneumoniae in different wards of an acute general hospital, Italy, June to December 2011.
Euro Surveill
; 17(33)2012 Aug 16.
Article
en En
| MEDLINE
| ID: mdl-22913977
ABSTRACT
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 bla(KPC3) 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.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones por Klebsiella
/
Infección Hospitalaria
/
Brotes de Enfermedades
/
Colistina
/
Klebsiella pneumoniae
/
Antibacterianos
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Euro Surveill
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
Año:
2012
Tipo del documento:
Article
País de afiliación:
Italia