title: Genetic relatedness among extended-spectrum beta-lactamase-producing Klebsiella pneumoniae outbreak isolates associated with colonization and invasive disease in a neonatal intensive care unit.
abstract: Pulsed-field gel electrophoresis typing of 60 extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBLKp) isolates obtained in a neonatal intensive care unit during an outbreak indicated the dissemination of two major bacterial genotypes associated with colonization and invasive disease: one composed by aminoglycoside-resistant isolates and the other by aminoglycoside-susceptible isolates. A urease-negative phenotype was observed among aminoglycoside-resistant ESBLKp. Six pairs of isolates from gastrointestinal (GI) colonization and isolates from invasive disease that occurred 3-23 days later were shown to belong to the same genotype, reinforcing a direct association between colonization and subsequent disease. These data indicate that screening for ESBLKp GI colonization in an outbreak setting may be useful to detect neonates at a higher risk of invasive disease.
authors.affiliation: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Valéria Câmara
authors.initials: VC
authors.lastname: de Almeida
authors.forename: Carmem Lúcia
authors.initials: CL
authors.lastname: Pessoa-Silva
authors.forename: Jorge Luiz Mello
authors.initials: JL
authors.lastname: Sampaio
authors.forename: Paulo Pinto
authors.initials: PP
authors.lastname: Gontijo Filho
authors.forename: Lúcia Martins
authors.initials: LM
authors.lastname: Teixeira
authors.forename: Beatriz Meurer
authors.initials: BM
authors.lastname: Moreira
mesh_terms: D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D016521:Electrophoresis, Gel, Pulsed-Field; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007710:Klebsiella Infections / Q000453:epidemiology*; D007711:Klebsiella pneumoniae / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001618:beta-Lactamases