Sonia Isabel Cuervo1, Ricardo Sánchez2, Julio César Gómez-Rincón3, Cielo Almenares4, Juan Pablo Osorio1, María José Vargas1. 1. Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia. 2. Instituto Nacional de Cancerología, Bogotá, D.C, Colombia. 3. Grupo de Investigación en Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas, GREICAH, Universidad Nacional de Colombia, Bogotá, D.C, Colombia. 4. Comité de Infecciones, Instituto Nacional de Cancerología, E.S.E, Bogotá, D.C, Colombia.
Abstract
INTRODUCTION: 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. MATERIALS AND 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.
INTRODUCTION: 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. MATERIALS AND 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.