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Original Article
- Infection
- Outbreak of Imipenemase-1-Producing Carbapenem-Resistant Klebsiella pneumoniae in an Intensive Care Unit
- Jin Young Lee, Ji Young Park, Je Hun Kim, Young Hee Lee, Hee Young Yang, Jung Sik Yoo
- Korean J Crit Care Med. 2017;32(1):29-38. Published online December 29, 2016
- DOI: https://doi.org/10.4266/kjccm.2016.00731
- 10,382 View
- 213 Download
- 3 Web of Science
- 3 Crossref
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Abstract
PDF - Background
Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported.
Methods
Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame.
Results
During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions.
Conclusions
This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission. -
Citations
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- Alkyl deoxyglycoside-polymyxin combinations against critical priority carbapenem-resistant gram-negative bacteria
Ana M. de Matos, Patrícia Calado, Mónica Miranda, Rita Almeida, Amélia P. Rauter, M. Conceição Oliveira, Vera Manageiro, Manuela Caniça
Scientific Reports.2024;[Epub] CrossRef - Genotypic Distribution and Antimicrobial Susceptibilities of Carbapenemase-Producing Enterobacteriaceae Isolated From Rectal and Clinical Samples in Korean University Hospitals Between 2016 and 2019
Seri Jeong, Nuri Lee, Min-Jeong Park, Kibum Jeon, Han-Sung Kim, Hyun Soo Kim, Jae-Seok Kim, Wonkeun Song
Annals of Laboratory Medicine.2022; 42(1): 36. CrossRef - Characterization of Infections with Vancomycin-Intermediate Staphylococcus aureus (VISA) and Staphylococcus aureus with Reduced Vancomycin Susceptibility in South Korea
Jung Wan Park, Hyungmin Lee, Jung Wook Kim, Bongyoung Kim
Scientific Reports.2019;[Epub] CrossRef
- Alkyl deoxyglycoside-polymyxin combinations against critical priority carbapenem-resistant gram-negative bacteria
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