title: Outbreak of KPC-3-producing, and colistin-resistant, Klebsiella pneumoniae infections in two Sicilian hospitals.
abstract: We report the first outbreak caused by colistin-resistant Klebsiella pneumoniae producing KPC-3 carbapenamase in two Italian hospitals. This spread occurred in 1 month, and was caused by eight colistin-resistant and carbapenem-resistant Klebsiella pneumoniae isolates from eight patients. A further three isolates were obtained from the intestinal tract and pharyngeal colonization. All isolates were multidrug-resistant (MDR), including being resistant to colistin, but they were susceptible to gentamicin and tigecycline. PCR detection showed that all isolates harboured the bla(KPC-3) gene associated with bla(SHV-11) , bla(TEM-1) and bla(OXA-9) . All K. pneumoniae isolates, genotyped by pulsed-field gel electrophoresis and multilocus sequence typing, belonged to the same sequence type (ST)258 clone. From our data and a review of the international literature, K. pneumoniae ST258 seems to be the most widespread genetic background for KPC dissemination in Europe.
authors.affiliation: Department of Bio-Medical Sciences, Section of Microbiology, University of Catania, Catania, Italy. mezzate@unict.it
authors.forename: M L
authors.initials: ML
authors.lastname: Mezzatesta
authors.forename: F
authors.initials: F
authors.lastname: Gona
authors.forename: C
authors.initials: C
authors.lastname: Caio
authors.forename: V
authors.initials: V
authors.lastname: Petrolito
authors.forename: D
authors.initials: D
authors.lastname: Sciortino
authors.forename: A
authors.initials: A
authors.lastname: Sciacca
authors.forename: C
authors.initials: C
authors.lastname: Santangelo
authors.forename: S
authors.initials: S
authors.lastname: Stefani
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000096:biosynthesis / Q000378:metabolism*; D015373:Bacterial Typing Techniques / Q000379:methods; D003091:Colistin / Q000494:pharmacology*; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D006761:Hospitals; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests / Q000379:methods; D012802:Sicily / Q000453:epidemiology; D001618:beta-Lactamases / Q000096:biosynthesis / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases; C495220:beta-lactamase KPC-3, Klebsiella pneumoniae; D003091:Colistin