title: [Behavior of carbapenemase-producing Klebsiella pneumoniae cases in cancer patients at a third level hospital in Bogotá, D.C].
abstract: BACKGROUND
  The presence of carbapenemase-producing Enterobacteriaceae in hospitals is increasingly common. Patients with advanced cancer who require invasive means for diagnosis, treatment or palliative care, and the use of broad-spectrum antimicrobials to treat secondary infections show increased susceptibility to infections caused by these bacteria.
  
  
  OBJECTIVE
  To report the behavior of carbapenemase-producing Klebsiella pneumoniae (CPKP) isolates at the Instituto Nacional de Cancerología in Bogotá between January 2010 and December 2012.
  
  
  METHODS
  By analyzing the database kept by the infection committee of the institution, as well as the records of patients with CPKC isolates, we identified and described the epidemiology of detected cases. Outbreaks were determined by using quality control statistical tools.
  
  
  RESULTS
  Between January 2010 and December 2012, we found 45 patients with CPKC isolates recovered from any sample. There were more isolates from patients with malignant solid tumors. CPKC isolates from urine samples were more often recovered; 17.7% of CPKC isolates corresponded to colonization, and 82.3% to infection; 35.5% of patients (16/45) survived. We identified two outbreaks during this period, which were controlled using a multimodal approach.
  
  
  CONCLUSIONS
  This study found that CPKC presence is more frequent as infection than as colonization. During the two years of the study we detected two outbreaks, which were controlled by limiting multi-resistant bacteria cross transmission using conventional control strategies.
authors: Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
authors: Sonia Isabel
authors: SI
authors: Cuervo
authors: Instituto Nacional de Cancerología, Bogotá, D.C, Colombia.
authors: Ricardo
authors: R
authors: Sánchez
authors: Grupo de Investigación en Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas, GREICAH, Universidad Nacional de Colombia, Bogotá, D.C, Colombia.
authors: Julio César
authors: JC
authors: Gómez-Rincón
authors: Comité de Infecciones, Instituto Nacional de Cancerología, E.S.E, Bogotá, D.C, Colombia.
authors: Cielo
authors: C
authors: Almenares
authors: Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
authors: Juan Pablo
authors: JP
authors: Osorio
authors: Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
authors: María José
authors: MJ
authors: Vargas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000378:metabolism*; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D016208:Databases, Factual; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D012150:Polymorphism, Restriction Fragment Length; D012189:Retrospective Studies; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase