title: Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary hospital.
abstract: The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR) bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. Wedescribe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections.
authors.affiliation: Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria; and Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, South Africa. vhudzani@gmail.com.
authors.forename: V S
authors.initials: VS
authors.lastname: Tshisevhe
authors.forename: M R
authors.initials: MR
authors.lastname: Lekalakala
authors.forename: N
authors.initials: N
authors.lastname: Tshuma
authors.forename: S
authors.initials: S
authors.lastname: Janse van Rensburg
authors.forename: N
authors.initials: N
authors.lastname: Mbelle
mesh_terms: D000328:Adult; D015780:Carbapenems / Q000627:therapeutic use*; D060085:Coinfection / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D003668:Pressure Ulcer / Q000453:epidemiology / Q000382:microbiology; D011532:Providencia / Q000502:physiology*; D013019:South Africa; D062606:Tertiary Care Centers; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D014946:Wound Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D015780:Carbapenems