title: The emergence of multidrug-resistant Klebsiella pneumoniae of international clones ST13, ST16, ST35, ST48 and ST101 in a teaching hospital in the Paris region.
abstract: Despite infection control measures, an important increase in the extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae incidence density occurred in our hospital from 2006 onwards. This study, focusing on the 2005-2007 period, was performed in an attempt to explain this increase. ESBLs were characterized, isolates were typed by ERIC2-PCR, and sequence type (ST) of clustered isolates was determined. Temporal-spatial relationships of patients were analysed to assess possible cross-contamination. Of the 74 ESBL-producing isolates, 30 (40%) were detected at admission, 53 (71∙5%) produced CTX-M enzymes, 40 displayed unique ERIC2-PCR profiles and 34 were assigned into six clusters: ST16 (n=21), ST101, ST48, ST35, ST13, and ST436. Relationships were identified in 22 of the 34 patients harbouring clustered isolates. This study highlights the complex epidemiology of ESBL-producing K. pneumoniae in the mid-2000s with potential cross-contamination for only 30% of the 74 patients in our hospital, and the emergence of clones that are currently spreading worldwide.
authors.affiliation: Microbiology Department, Hôpital L. Mourier, AP-HP, Colombes, France.
authors.forename: G
authors.initials: G
authors.lastname: Marcade
authors.forename: S
authors.initials: S
authors.lastname: Brisse
authors.forename: S
authors.initials: S
authors.lastname: Bialek
authors.forename: E
authors.initials: E
authors.lastname: Marcon
authors.forename: V
authors.initials: V
authors.lastname: Leflon-Guibout
authors.forename: V
authors.initials: V
authors.lastname: Passet
authors.forename: R
authors.initials: R
authors.lastname: Moreau
authors.forename: M-H
authors.initials: MH
authors.lastname: Nicolas-Chanoine
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000378:metabolism; D058885:Multilocus Sequence Typing; D010297:Paris / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases