title: Outbreak due to a Klebsiella pneumoniae strain harbouring KPC-2 and VIM-1 in a German university hospital, July 2010 to January 2011.
abstract: We describe the epidemiology and characteristics of the pathogen and patients (n=7) associated with an outbreak of a carbapenem-resistant Klebsiella pneumoniae (CRKP) strain in a German university hospital from July 2010 to January 2011. Species identification and detection of carbapenem resistance were carried out using standard microbiological procedures. Carbapenemases were detected by phenotypic methods and specific polymerase chain reactions (PCRs). DNA fingerprinting profiles were performed with repetitive sequence-based PCR. Medical records of colonised or infected patients were retrospectively reviewed. Antibiotic resistance profiles, PCR-specific amplification products and genotyping demonstrated that the outbreak occurred because of the spread of a single CRKP clone harbouring both KPC-2 and VIM-1. Five of the seven patients had invasive infections with the CRKP strain; the deaths of four of them were directly related to the infection. Early implementation of infection control interventions brought about efficient containment of further cross-transmission. Rapid dissemination of carbapenemase-producing Enterobacteriaceae is a serious concern in patient care and is a problem that has emerged in western Europe.
authors.affiliation: Institute of Medical Microbiology, University Hospital Essen, University of Duisburg- Essen, Essen, Germany. joerg.steinmann@uk-essen.de
authors.forename: J
authors.initials: J
authors.lastname: Steinmann
authors.forename: M
authors.initials: M
authors.lastname: Kaase
authors.forename: S
authors.initials: S
authors.lastname: Gatermann
authors.forename: W
authors.initials: W
authors.lastname: Popp
authors.forename: E
authors.initials: E
authors.lastname: Steinmann
authors.forename: M
authors.initials: M
authors.lastname: Damman
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.forename: F
authors.initials: F
authors.lastname: Saner
authors.forename: J
authors.initials: J
authors.lastname: Buer
authors.forename: Pm
authors.initials: P
authors.lastname: Rath
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002228:Carbenicillin / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D016172:DNA Fingerprinting; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; C417264:VIM-1 metallo-beta-lactamase; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases; D002228:Carbenicillin