A Madueño1, J González García2, S Fernández-Romero3, J Oteo3, M Lecuona4. 1. Department of Microbiology and Infection Control, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain. Electronic address: ana_madueno@hotmail.com. 2. Department of Hospital Pharmacy, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain. 3. Laboratory of Reference and Research in Resistance to Antibiotics and Infections Related to Health Care, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Spain. 4. Department of Microbiology and Infection Control, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain; Department of Preventive Medicine and Public Health, Universidad de la Laguna, La Laguna, Santa Cruz de Tenerife, Spain.
Abstract
BACKGROUND: Healthcare-associated infections caused by Klebsiella pneumoniae isolates are increasing and few effective antibiotics are currently available to treat patients. AIM: To assess the epidemiology, molecular basis, clinical features, and outcomes in the acquisition and dissemination of OXA-48-producing K. pneumoniae (OXA48KP) in a tertiary Spanish hospital between October 2013 and December 2015. METHODS: Clinical, demographic, and microbiological data of patients with OXA48KP in clinical samples were collected from medical records. Carbapenemase genes were detected by polymerase chain reaction. Genetic relationships were determined by pulsed-field gel electrophoresis and multi-locus sequence typing. FINDINGS: In all, 116 episodes of OXA48KP in clinical samples were identified. The most frequent types of infection were urinary tract (N = 43, 42%), secondary bloodstream (N = 18, 17%), and surgical site infection (N = 17, 17%). More than one-quarter (28%) of infected patients died in hospital. Among infected patients (N = 90, 78%), infections were mainly classified as hospital-acquired (N = 70, 88%). A high number of OXA48KP isolates showed multidrug resistance, with highest susceptibility to colistin (86%), gentamicin (69%) and amikacin (59%). Most (87%) isolates were included in a main cluster. Seven (N = 8, 88%) isolates showed an identical allelic profile, associated with ST15. Only the isolate from cluster P8 was associated with ST29. The results confirm high dissemination of OXA48KP in our hospital due to the main clone ST15. OXA48KP infection was associated with a high mortality and was mainly hospital-acquired. CONCLUSION: This study highlights the importance of active surveillance programmes, especially those focusing on hospital readmissions in order to control the spread of carbapenemase-producing Enterobacteriaceae.
BACKGROUND: Healthcare-associated infections caused by Klebsiella pneumoniae isolates are increasing and few effective antibiotics are currently available to treat patients. AIM: To assess the epidemiology, molecular basis, clinical features, and outcomes in the acquisition and dissemination of OXA-48-producing K. pneumoniae (OXA48KP) in a tertiary Spanish hospital between October 2013 and December 2015. METHODS:Clinical, demographic, and microbiological data of patients with OXA48KP in clinical samples were collected from medical records. Carbapenemase genes were detected by polymerase chain reaction. Genetic relationships were determined by pulsed-field gel electrophoresis and multi-locus sequence typing. FINDINGS: In all, 116 episodes of OXA48KP in clinical samples were identified. The most frequent types of infection were urinary tract (N = 43, 42%), secondary bloodstream (N = 18, 17%), and surgical site infection (N = 17, 17%). More than one-quarter (28%) of infectedpatients died in hospital. Among infectedpatients (N = 90, 78%), infections were mainly classified as hospital-acquired (N = 70, 88%). A high number of OXA48KP isolates showed multidrug resistance, with highest susceptibility to colistin (86%), gentamicin (69%) and amikacin (59%). Most (87%) isolates were included in a main cluster. Seven (N = 8, 88%) isolates showed an identical allelic profile, associated with ST15. Only the isolate from cluster P8 was associated with ST29. The results confirm high dissemination of OXA48KP in our hospital due to the main clone ST15. OXA48KP infection was associated with a high mortality and was mainly hospital-acquired. CONCLUSION: This study highlights the importance of active surveillance programmes, especially those focusing on hospital readmissions in order to control the spread of carbapenemase-producing Enterobacteriaceae.
Authors: Rossana Abreu; Cristobalina Rodríguez-Álvarez; Beatriz Castro-Hernandez; Maria Lecuona-Fernández; Juan Carlos González; Yurena Rodríguez-Novo; Maria de Los Angeles Arias Rodríguez Journal: Vet Sci Date: 2022-06-03
Authors: Krystyna M Kazmierczak; Patricia A Bradford; Gregory G Stone; Boudewijn L M de Jonge; Daniel F Sahm Journal: Antimicrob Agents Chemother Date: 2018-11-26 Impact factor: 5.191
Authors: Willames M B S Martins; Marisa F Nicolas; Yang Yu; Mei Li; Priscila Dantas; Kirsty Sands; Edward Portal; Luiz G P Almeida; Ana Tereza R Vasconcelos; Eduardo A Medeiros; Mark A Toleman; Timothy R Walsh; Ana C Gales; Diego O Andrey Journal: mSphere Date: 2020-10-07 Impact factor: 4.389