title: Nosocomial outbreak of cross-infection due to multiple-antibiotic-resistant Klebsiella pneumoniae: characterization of the strain and antibiotic susceptibility studies.
abstract: A multiple-antibiotic-resistant (MAR) strain of Klebsiella pneumoniae was introduced into a pediatric ward and subsequently colonized neonates of two wards with several cases of systemic infection. This strain produced an extended-spectrum beta-lactamase and was resistant to cefotaxime, ceftazidime, and, among others, all aminoglycosides including amikacin. The majority of representative isolates examined with macrorestriction analysis of genomic DNA (pulsed-field gel electrophoresis) were identical. The strain was susceptible to the innate antibacterial systems operative in fresh defibrinated blood from two adults. Combined human blood/antimicrobial drug assays documented the in vitro bactericidal activity of carbapenems (meropenem was slightly more effective than imipenem), fluoroquinolones (ciprofloxacin and trovafloxacin), and polymyxin B against this MAR strain of K. pneumoniae.
authors.affiliation: Institut für Medizinische Mikrobiologie und Hygiene, Universität des Saarlandes, Homburg, Germany.
authors.forename: W H
authors.initials: WH
authors.lastname: Traub
authors.forename: I
authors.initials: I
authors.lastname: Schwarze
authors.forename: D
authors.initials: D
authors.lastname: Bauer
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D004196:Disease Outbreaks; D018432:Drug Resistance, Multiple; D024841:Fluoroquinolones; D006801:Humans; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D015780:Carbapenems; D024841:Fluoroquinolones