title: Outbreak of CTX-M-15-producing Klebsiella pneumoniae in the intensive care unit of a French hospital.
abstract: The CTX-M-15 extended spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae isolates were identified in 36 patients hospitalized from December 2006 to September 2007 in the medical intensive care unit (ICU) of the Bicêtre hospital, South Paris, France. The incidence of colonization and/or infection was 4.8%. Eighty-nine percent of the ESBL-producing K. pneumoniae isolates were acquired in the ICU, and only 8.3% of the patients were infected. Pulsed field gel electrophoresis (PFGE) analysis of the isolates showed that 32 isolates were clonally related and contained a 160-kb plasmid carrying the bla(CTX-M-15), bla(OXA-1), bla(TEM-1), and aac6'-Ib-cr genes. CTX-M-15-producing Escherichia coli isolates collected in the ward during the same period of time contained distinct plasmids and were not clonally related. This study highlights the possible occurrence of outbreaks due to CTX-M-producing K. pneumoniae within hospital settings, whereas CTX-Ms are mostly reported in E. coli in community-acquired infections.
authors.affiliation: Service de Bactériologie-Virologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Amelie
authors.initials: A
authors.lastname: Carrër
authors.forename: Ludovic
authors.initials: L
authors.lastname: Lassel
authors.forename: Nicolas
authors.initials: N
authors.lastname: Fortineau
authors.forename: Meriem
authors.initials: M
authors.lastname: Mansouri
authors.forename: Nadia
authors.initials: N
authors.lastname: Anguel
authors.forename: Christian
authors.initials: C
authors.lastname: Richard
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D004755:Enterobacteriaceae / Q000187:drug effects / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000235:genetics / Q000382:microbiology; D005602:France / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000235:genetics*; D007902:Length of Stay; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000235:genetics; D015363:Quinolones / Q000494:pharmacology; D012007:Rectum / Q000382:microbiology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D015363:Quinolones; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases