title: Investigation of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae outbreaks in Hungary between 2005 and 2008.
abstract: Fourteen outbreaks in Hungary between 2005 and 2008 caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KP) were epidemiologically investigated and the isolated pathogens were characterized by molecular techniques. Ten of the fourteen outbreaks occurred in adult wards and four in neonatal units affecting a total number of 73 patients. The 54% [40] of the patients developed bloodstream infections and 21.9%-21.9% [16] pneumonia and surgical site infections, respectively. The overall rate of mortality proved high: 36.9% [27]. Outbreaks in adults affected more patients, had higher attack rates, were more prolonged in duration and had a 6.9-fold higher mortality rate than outbreaks observed in neonates. The outbreaks in neonates were caused by SHV-type ESBL-producing klebsiellae, while in the "adult outbreaks" exclusively CTX-M-type ESBL-KP strains were involved. While the outbreak strains isolated from neonatal units could be assigned to a variety of pulsotypes, the previously described K. pneumoniae epidemic clones, ST15 and ST147, could be identified among the pathogens causing outbreaks in adult units.
authors.affiliation: National Center for Epidemiology Department of Hospital Epidemiology and Hygiene Budapest Hungary. szilagyi.emese@oek.antsz.hu
authors.forename: Emese
authors.initials: E
authors.lastname: Szilágyi
authors.forename: M
authors.initials: M
authors.lastname: Füzi
authors.forename: Ivelina
authors.initials: I
authors.lastname: Damjanova
authors.forename: Karolina
authors.initials: K
authors.lastname: Böröcz
authors.forename: Katalin
authors.initials: K
authors.lastname: Szonyi
authors.forename: A
authors.initials: A
authors.lastname: Tóth
authors.forename: K
authors.initials: K
authors.lastname: Nagy
mesh_terms: D000328:Adult; D000483:Alleles; D004269:DNA, Bacterial / Q000235:genetics; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000401:mortality; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D017720:Molecular Epidemiology; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D004269:DNA, Bacterial; C405902:GES-1 beta-lactamase; D001618:beta-Lactamases