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Peracute bovine mastitis caused by Klebsiella pneumoniae
Ribeiro, M.G.;Motta, R.G.;Paes, A.C.;Allendorf, S.D.;Salerno, T.;Siqueira, A.K.;Fernandes, M.C.;Lara, G.H.B.;
Arquivo Brasileiro de Medicina Veterinária e Zootecnia , 2008, DOI: 10.1590/S0102-09352008000200031
Abstract: relata-se a ocorrência de graves sintomas de mastite hiperaguda em vaca, causada por klebsiella pneumoniae, na terceira semana de lacta??o. descrevem-se aspectos epidemiológicos, sintomas clínicos, procedimentos de diagnóstico microbiológico, conduta terapêutica e medidas de controle.
Atypical phenotypic characteristics of klebsiella pneumoniae isolates from an outbreak in a neonatal intensive care unit in Brazil
Otman, J.;Perugini, M.E.;Tognim, M.C.B.;Vidotto, M.C.;
Brazilian Journal of Microbiology , 2007, DOI: 10.1590/S1517-83822007000200016
Abstract: extended-spectrum b-lactamase-producing (esbl) klebsiella sp.isolates from an outbreak in a neonatal intensive care unit (nicu) at a teaching hospital in londrina, paraná state, brazil, presented atypical phenotypic characteristics that hampered their identification and the distinction between klebsiella and enterobacter species. ten isolates were identified as k. pneumoniae due to negative reactions for motility and inducible b-lactamase test (esbl and ampc) despite being positive for ornithyne descarboxilase. these isolates were genotyped by ribotyping and polymerase chain reaction (pcr) with repetitive extragenic palindromic sequences (rep). ribotyping by means of an automated instrument and ecori and pvu ii as restriction enzymes resulted indetection of k. pneumoniae subspecie pneumoniae ribo1 222-36-s-5 ribotype. typing by rep-pcr showed that the 17 isolates from the outbreak were highly similar, belonging to one cluster with 100% of similarity, and that they presented more than 70% of similarity with k. pneumoniae atcc 13883 and atcc 10031, and 25% of similarity with e. aerogenes cdc 1680. in conclusion, the isolates of the outbreak were identified as klebsiella pneumoniae, despite presenting ornithyne descarboxilase enzyme, which is an atypical characteristic of this klebsiella species.
Outbreak of Ampicillin/Piperacillin-Resistant Klebsiella Pneumoniae in a Neonatal Intensive Care Unit (NICU): Investigation and Control Measures  [PDF]
Giuliana Fabbri,Manuela Panico,Laura Dallolio,Roberta Suzzi,Matilde Ciccia,Fabrizio Sandri,Patrizia Farruggia
International Journal of Environmental Research and Public Health , 2013, DOI: 10.3390/ijerph10030808
Abstract: Klebsiella pneumoniae is a frequent cause of infectious outbreaks in Neonatal Intensive Care Units (NICUs). The aim of this paper is to describe an outbreak occurred in a 13-bed NICU and the control measures adopted in order to interrupt the chain of transmission. We described the microbiological investigations, the NICU staff compliance to the infection control measures by means of a specifically designed check-list and the control measures adopted. Six cases of primary bloodstream infections sustained by ampicillin/piperacillin-resistant Klebsiella pneumoniae were observed over a two-month period. One culture obtained from a 12% saccarose multiple-dose solution allowed the growth of Klebsiella pneumoniae. During the inspections performed by the Hospital Infection Control Team, using the check-list for the evaluation of the NICU staff compliance to the infection control measures, several breaches in the infection control policy were identified and control measures were adopted. In our case the definition of a specific check-list led to the adoption of the correct control measures. Further studies would be helpful in order to develop a standard check-list able to identify critical flows in the adhesion to the guidelines. It could be used in different NICUs and allow to obtain reproducible levels of infection control.
Klebsiella pneumoniae Carbapenamase (KPC) Outbreak in a Multispeciality Cancer Hospital—An Emerging Superbug  [PDF]
Sulav Sapkota, Shobha K. Ganesan, Mona Priyadarshini, Shobha Savitha A., Radheshyam Naik
Advances in Infectious Diseases (AID) , 2019, DOI: 10.4236/aid.2019.93012
Abstract: Aim: To identify, analyse and control the outbreak of Carbapenamase producing Klebsiella pneumoniae. Objectives: 1) To detect multidrug resistant K. pneumoniae at the earliest and isolate patients. 2) To find out the predisposing causes for the occurrence of this outbreak. 3) To break the chain of infection transmission. 4) To reduce the risk of Hospital acquired infections. Methods: This retrospective study along with the surveillance was conducted from January 2017 to March 2017 at HCG multispecialty cancer hospital, Bangalore, India. Results: Total 15 patients were diagnosed with KPC infection during the first month of the study period. Those affected were mostly Male patients (73%), admitted in ICU (73%) for further treatment. In our study, the incidence of KPC infection was mostly found with bloodstream infections (60%), mostly seen in those with central lines (80%) followed by patients on ventilatory support (66%). Before the outbreak of KPC infection, all the patients (100%) had already been treated with higher antibiotics including Carbapenems. In our study, only nine out of fifteen patients (60%) could be salvaged with treatment and were discharged. Conclusions: Hospital Infection Control Committee’s regular screening and the training of healthcare professionals are vital for the control of the outbreak.
Outbreak of carbapenem-resistant Klebsiella pneumoniae: two-year epidemiologic follow-up in a tertiary hospital
Pereira, Graziella Hanna;Garcia, Doroti O;Mostardeiro, Marcelo;Fanti, Karina SVN;Levin, Anna S;
Memórias do Instituto Oswaldo Cruz , 2013, DOI: 10.1590/S0074-02762013000100019
Abstract: this study describes a carbapenem-resistant klebsiella pneumoniae (crkp) outbreak that occurred from october 2008-december 2010. polymerase chain reaction assays were performed to detect the blakpc gene and molecular typing was performed using pulsed-field gel electrophoresis (pfge). there were 33 crkp infections; pfge revealed five genotypes: genotype a in five (15%), b in 18 (55%), c in eight (24%) and two unique profiles. genotype b was disseminated in all hospital units and belonged to the same clone identified in 11 different hospitals in the state of s?o paulo. sixteen (48%) patients died. seven isolates (21%) were resistant to polymyxin b and 45% were resistant to tigecycline and amikacin.
Molecular epidemiology of Multidrug resistant Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae outbreak in a neonatal intensive care unit  [cached]
Parveen R Mohamudha,Acharya N Srinivas,Dhodapkar Rahul,B N Harish
International Journal of Collaborative Research on Internal Medicine & Public Health , 2010,
Abstract: Background: Extended spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae have been occasionally reported as a cause of septicemia outbreak among pediatric patients in medical literature. We aimed to study the source of an outbreak of ESBL-producing K. pneumoniae in the Neonatal Intensive care Unit (NICU) at a tertiary care hospital in South India. Methods: The outbreak was investigated by phenotypically typing the isolates followed by random amplified polymorphic DNA analysis (RAPD). A total of 31 K. pneumoniae, consisting of 27 blood isolates from neonates and 4 environmental isolates were studied. Antibiotic susceptibility patterns were determined using standard disc diffusion methods; ESBL production was tested both phenotypically and genotypically. The strains were typed using two primers AP4 and HLWL74. Results: Except 2 environmental strains, all were found to be ESBL producers and of ESBL types TEM-1, SHV-12 and CTX-M- 15. Two different antibiotic resistance patterns were identified and the RAPD typing revealed two profiles. Phenotypic and genotypic analyses showed that 2 environmental strains had been responsible for the outbreak. Conclusion: Safe clinical practices should be followed in neonatal wards to prevent spread of infection. This is the first report of blaCTX-M-15 producing K.pneumoniae and the first outbreak in our hospital due to CTX-M-15 producing K.pneumoniae.
Nosocomial outbreak of septicaemia in neonatal intensive care unit due to extended spectrum β-lactamase producing Klebsiella pneumoniae showing multiple mechanisms of drug resistance  [cached]
Rastogi V,Nirwan P,Jain S,Kapil A
Indian Journal of Medical Microbiology , 2010,
Abstract: A total of 14 phenotypically similar clinical isolates of Klebsiella pneumoniae, resistant to multiple drugs including cefotaxime and ceftazidime, were isolated from blood of neonates admitted to neonatal intensive care unit (NICU) within a short span of 10 days. Alarmed at the possibility of occurrence of outbreak, a thorough investigation was done. Microbiological sampling of the NICU and labour room (LR) environment yielded 12 K. pneumoniae isolates. The presence of extended spectrum β-lactamase (ESBL) in the clinical and environmental strains was detected by double-disk synergy test (DDST), CLSI phenotypic confirmatory disk diffusion test (PCDDT) and E-test ESBL strips. Amp-C screen (disk) test was done to determine Amp-C β-lactamase production. 100% clinical strains, 57% NICU strains and 80% LR strains were ESBL positive. 57% clinical, 43% NICU and 20% LR strains were Amp-C screen positive. Polymerase chain reaction (PCR) of representative ESBL positive (10 clinical and 5 environmental) strains showed CTX gene and TEM and/or SHV gene in all. K. pneumoniae showing multiple mechanisms of drug resistance was responsible for the outbreak.
Brote por Klebsiella pneumoniae multiresistente y productora de β-lactamasa de espectro extendido en una unidad de alto riesgo neonatal Outbreak of multiresistant and extended spectrum β-lactamase producing Klebsiella pneumoniae in a high risk neonatal unit  [cached]
A. Carolina González R,Florimar Gil G,Marisé Solórzano R,Jhon Cruz G
Revista chilena de infectología , 2011,
Abstract: Klebsiella pneumoniae productora de β-lactamasa de espectro expandido (BLEE) ha jugado un papel importante como causa de infecciones en la unidad de alto riesgo neonatal (UARN) del Instituto Autónomo Hospital Universitario de Los Andes (IAHULA). En el presente trabajo se describe un brote ocasionado por esta bacteria en los neonatos hospitalizados en dicha unidad durante el mes de febrero 2007, así como también, cepas aisladas en los meses siguientes al brote y además, se estudia el ambiente y el personal, como posible fuente de esta bacteria. Las cepas de K. pneumoniae aisladas del brote eran del mismo fenotipo de resistencia, productoras de (3LEE tipo TEM y SHV y pertenecían al mismo genotipo que las cepas aisladas de las manos y de las soluciones jabonosas, posible fuente de infección, lo cual indica que se trataba del mismo clon. El brote se resolvió usando dos importantes medidas: reforzando el lavado de manos y con la indicación oportuna de imipenem a los neonatos afectados. Klebsiella pneumoniae as a producer of extended spectrum beta-lactamase (ESBL) has played an important role as a cause of infection in the neonatal high risk unit (NHRU) of the Autonomous Hospital Institute of the Universidad de Los Andes (AHIULA). In this paper an outbreak caused by this bacterial specie that affected neonates hospitalized in this unit during February 2007 is described. Besides, the environment and the personnel were studied as possible sources of this organism. The strains of K. pneumonia isolated from the outbreak had the same resistance phenotype, produced ESBL type TEM and SHV and belonged to the same genotype as the isolated strains from the hands and the soapy solutions, possible sources of infection. This indicates that it was the same clone. The outbreak was resolved using two important measurements: reinforcing hand washing and with the opportune treatment of neonates with imipenem.
A Long-Term Low-Frequency Hospital Outbreak of KPC-Producing Klebsiella pneumoniae Involving Intergenus Plasmid Diffusion and a Persisting Environmental Reservoir  [PDF]
St?le Tofteland, Umaer Naseer, Jan Helge Lislevand, Arnfinn Sundsfjord, ?rjan Samuelsen
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0059015
Abstract: Background To study the molecular characteristics of a long-term, low frequency outbreak of blaKPC-2 in a low prevalence setting involving the hospital environment. Methodology/Principal Findings KPC-producing bacteria were screened by selective chromogenic agar and Real-Time PCR. The presence of antibiotic resistance genes was ascribed by PCRs and subsequent sequencing, and the KPC-producing isolates were phylogenetically typed using PFGE and multi-locus sequence typing. BlaKPC-2-plasmids were identified and analysed by S1-nuclease-PFGE hybridization and PCR based replicon typing. A ~97 kb IncFII plasmid was seen to carry blaKPC-2 in all of the clinical isolates, in one of the isolates recovered from screened patients (1/136), and in the Klebsiella pneumoniae and Enterobacter asburiae isolates recovered from the environment (sinks) in one intensive care unit. The K. pneumoniae strain ST258 was identified in 6 out of 7 patients. An intergenus spread to E. asburiae and an interspecies spread to two different K. pneumoniae clones (ST27 and ST461) of the blaKPC-2 plasmid was discovered. K. pneumoniae ST258 and genetically related E. asburiae strains were found in isolates of both human and environmental origins. Conclusions/Significance We document a clonal transmission of the K. pneumoniae ST258 strain, and an intergenus plasmid diffusion of the IncFII plasmid carrying blaKPC-2 in this outbreak. A major reservoir in the patient population could not be unveiled. However, the identification of a persisting environmental reservoir of strains with molecular determinants linked to human isolates, suggests a possible role of the environment in the maintenance of this long-term outbreak.
Klebsiella pneumoniae outbreak in a cancer unit of a general hospital: predisposing factors and evaluation of the impact of intervention measures
Silva, Cristiane Pavanello Rodrigues;Amarante, Jorge Manoel Buchdid;Lacerda, Rúbia Aparecida;Biancalana, Maria Lúcia das Neves;
Brazilian Journal of Infectious Diseases , 2005, DOI: 10.1590/S1413-86702005000300005
Abstract: we made a retrospective cohort study of a primary bloodstream infection outbreak in patients of a cancer unit in a general hospital, evaluated the impact of intervention measures and investigated the predisposing factors. the targeted predisposing factors were selected based on the medical literature. the data were treated with univariate analysis to calculate the relative risk, and statistical significance was set at p<0.05. the presence of a long-term totally-implanted central venous catheter appears to be a predisposing factor, while a peripheral venous catheter appears to have offered protection from infection. this is reinforced by fact that intervention measures controlled the outbreak, suggesting cross-contamination from a common source. these findings corroborate the fundamental role of the hospital infection control service in early intervention and reinforce the need for continued training of health professionals that perform this type of care.
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