title: Rapid molecular technique analysis of a KPC-3-producing Klebsiella pneumoniae outbreak in an Italian surgery unit.
abstract: The rapid emergence of KPC-producing Klebsiella pneumoniae has become a serious problem in health-care settings, increasing in frequency worldwide. These infections are worrisome, since the antimicrobial treatment options for infections due to multidrug-resistant  strains are very limited, and outbreaks must be rapidly detected and controlled. A semi-automated, repetitive-sequence-based PCR (rep-PCR) instrument (DiversiLab system) was evaluated in comparison with the pulse-field gel electrophoresis (PFGE) and multilocus sequence typing to investigate  the outbreak of KPC-producing K. pneumoniae in a surgery unit at the University Hospital of Verona, Italy, as a rapid method for outbreak investigations. A selection of seven epidemiologically related K. pneumoniae showing resistance to carbapenem and three epidemiologically  unrelated K. pneumoniae isolates were collected from patient with hospital-acquired infection. Among the epidemiologically related isolates, PFGE and Rep-PCR identified a unique pattern with more than 90% of homology. The concordance between DiversiLab and PFGE results confirmed the  usefulness of rapid molecular techniques to investigate outbreaks due to multidrug-resistant bacteria. Moreover, this result could meet the international need for a harmonised typing tool, allowing the implementation of strict control measures to prevent dissemination of these organisms in  health-care settings.
authors.affiliation: Department of Pathology and Diagnostics, University of Verona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mazzariol
authors.forename: G
authors.initials: G
authors.lastname: Lo Cascio
authors.forename: P
authors.initials: P
authors.lastname: Ballarini
authors.forename: M
authors.initials: M
authors.lastname: Ligozzi
authors.forename: F
authors.initials: F
authors.lastname: Soldani
authors.forename: R
authors.initials: R
authors.lastname: Fontana
authors.forename: G
authors.initials: G
authors.lastname: Cornaglia
mesh_terms: D000005:Abdomen / Q000382:microbiology* / Q000601:surgery*; D001426:Bacterial Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D006785:Hospitals, University; D006801:Humans; D007558:Italy; D007710:Klebsiella Infections / Q000175:diagnosis* / Q000235:genetics / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D016133:Polymerase Chain Reaction; D012091:Repetitive Sequences, Nucleic Acid / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D001618:beta-Lactamases; C495220:beta-lactamase KPC-3, Klebsiella pneumoniae