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Titolo:
Outbreak of infection with multidrug-resistant Klebsiella pneumoniae carrying bla(IMP-8) in a university medical center in Taiwan
Autore:
Yan, JJ; Ko, WC; Tsai, SH; Wu, HM; Wu, JJ;
Indirizzi:
Natl Cheng Kung Univ, Coll Med, Dept Med Technol, Tainan 70101, Taiwan Natl Cheng Kung Univ Tainan Taiwan 70101 d Technol, Tainan 70101, Taiwan Natl Chung Cheng Univ, Ctr Med, Dept Pathol, Tainan, Taiwan Natl Chung Cheng Univ Tainan Taiwan tr Med, Dept Pathol, Tainan, Taiwan Natl Chung Cheng Univ, Ctr Med, Dept Med, Tainan, Taiwan Natl Chung Cheng Univ Tainan Taiwan , Ctr Med, Dept Med, Tainan, Taiwan
Titolo Testata:
JOURNAL OF CLINICAL MICROBIOLOGY
fascicolo: 12, volume: 39, anno: 2001,
pagine: 4433 - 4439
SICI:
0095-1137(200112)39:12<4433:OOIWMK>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
METALLO-BETA-LACTAMASE; AERUGINOSA CLINICAL ISOLATE; GENE BLA(IMP); SERRATIA-MARCESCENS; IDENTIFICATION; CASSETTES; VIM-1; BORNE; DNA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Wu, JJ Natl Cheng Kung Univ, Coll Med, Dept Med Technol, 1 Univ Rd, Tainan70101,Taiwan Natl Cheng Kung Univ 1 Univ Rd Tainan Taiwan 70101 an 70101,Taiwan
Citazione:
J.J. Yan et al., "Outbreak of infection with multidrug-resistant Klebsiella pneumoniae carrying bla(IMP-8) in a university medical center in Taiwan", J CLIN MICR, 39(12), 2001, pp. 4433-4439

Abstract

Klebsiella pneumoniae strains with the transferable carbapenem-hydrolyzingmetallo-beta -lactamases, which include IMP- and VIM-type enzymes, remain extremely rare. To investigate whether IMP- or VIM-producing K. pneumoniae isolates had spread at a university medical center in Taiwan, a total of 3,458 clinical isolates of K. pneumoniae consecutively collected in 1999 and 2000 were tested by the agar diffusion method, colony hybridization, PCR, and nucleotide sequencing. A total of 40 isolates (1.2%), or 17 nonrepetitive isolates, from 16 patients were found to carry bla(IMP-8) a metallo-beta -lactamase gene recently identified from a K. pneumoniae strain in Taiwan. Carriage of bla(VIM) or other bla(IMP) genes was detected in none of the remaining isolates. Of the 17 nonrepetitive bla(IMP-8)-positive isolates, 15 isolates (88.2%) appeared susceptible to imipenem (MICs, less than or equalto4 mug/ml) and meropenem (MICs, less than or equal to1 mug/ml), indicating the difficulty in detecting bla(IMP-8) in K. pneumoniae by routine susceptibility tests; 14 isolates (82.4%) produced SHV-12 as well; and 14 isolates (82.4%) were also resistant to fluoroquinolones. The organisms caused wound infections in eight patients and bloodstream infections in three patients. They were not directly associated with the death of nine patients. Before the recovery of the bia(IMP-8)-positive isolates, all 16 patients had undergone various surgical procedures, and 15 patients had been admitted to the surgical intensive care unit, suggesting a nosocomial outbreak. Two majorpatterns were observed by pulsed-field gel electrophoresis for 14 of the 17 nonrepetitive isolates, indicating that the clonal spread was mainly responsible for the outbreak.

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Documento generato il 26/05/20 alle ore 05:50:04