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Published in: Infection 3/2014

01-06-2014 | Brief Report

First documented outbreak of KPC-2-producing Klebsiella pneumoniae in Switzerland: infection control measures and clinical management

Authors: E. Lemmenmeier, P. Kohler, T. Bruderer, D. Goldenberger, G.-R. Kleger, M. Schlegel

Published in: Infection | Issue 3/2014

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Abstract

We report the epidemiological and clinical features of the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) type 2 in Switzerland. The outbreak took place in the medical intensive care unit (MICU) of our tertiary care hospital and affected three severely ill patients. After the implementation of strict infection control measures, no further patients colonised with KPC-KP could be detected by the screening of exposed patients. Successful treatment of patients infected with KPC-KP consisted of a combination therapy of meropenem, colistin and tigecycline.
Literature
1.
go back to reference Cantón R, Akóva M, Carmeli Y, Giske CG, Glupczynski Y, Gniadkowski M, et al. Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe. Clin Microbiol Infect. 2012;18:413–31.PubMedCrossRef Cantón R, Akóva M, Carmeli Y, Giske CG, Glupczynski Y, Gniadkowski M, et al. Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe. Clin Microbiol Infect. 2012;18:413–31.PubMedCrossRef
3.
go back to reference Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD, et al. Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother. 2001;45:1151–61.PubMedCentralPubMedCrossRef Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD, et al. Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother. 2001;45:1151–61.PubMedCentralPubMedCrossRef
4.
go back to reference Giani T, Pini B, Arena F, Conte V, Bracco S, Migliavacca R, et al. Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011. Euro Surveill. 2013;18. pii: 20489. Giani T, Pini B, Arena F, Conte V, Bracco S, Migliavacca R, et al. Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011. Euro Surveill. 2013;18. pii: 20489.
5.
go back to reference Giani T, D’Andrea MM, Pecile P, Borgianni L, Nicoletti P, Tonelli F, et al. Emergence in Italy of Klebsiella pneumoniae sequence type 258 producing KPC-3 Carbapenemase. J Clin Microbiol. 2009;47:3793–4.PubMedCentralPubMedCrossRef Giani T, D’Andrea MM, Pecile P, Borgianni L, Nicoletti P, Tonelli F, et al. Emergence in Italy of Klebsiella pneumoniae sequence type 258 producing KPC-3 Carbapenemase. J Clin Microbiol. 2009;47:3793–4.PubMedCentralPubMedCrossRef
6.
go back to reference Cuzon G, Naas T, Demachy M-C, Nordmann P. Nosocomial outbreak of Klebsiella pneumoniae harbouring bla(KPC-3) in France subsequent to a patient transfer from Italy. Int J Antimicrob Agents. 2012;39:448–9.PubMedCrossRef Cuzon G, Naas T, Demachy M-C, Nordmann P. Nosocomial outbreak of Klebsiella pneumoniae harbouring bla(KPC-3) in France subsequent to a patient transfer from Italy. Int J Antimicrob Agents. 2012;39:448–9.PubMedCrossRef
8.
go back to reference Poirel L, Lienhard R, Potron A, Malinverni R, Siegrist HH, Nordmann P. Plasmid-mediated carbapenem-hydrolysing β-lactamase KPC-2 in a Klebsiella pneumoniae isolate from Switzerland. J Antimicrob Chemother. 2011;66:675–6.PubMedCrossRef Poirel L, Lienhard R, Potron A, Malinverni R, Siegrist HH, Nordmann P. Plasmid-mediated carbapenem-hydrolysing β-lactamase KPC-2 in a Klebsiella pneumoniae isolate from Switzerland. J Antimicrob Chemother. 2011;66:675–6.PubMedCrossRef
9.
go back to reference Babouee B, Widmer AF, Dubuis O, Ciardo D, Droz S, Betsch BY, et al. Emergence of four cases of KPC-2 and KPC-3-carrying Klebsiella pneumoniae introduced to Switzerland, 2009–10. Euro Surveill. 2011;16. pii: 19817. Babouee B, Widmer AF, Dubuis O, Ciardo D, Droz S, Betsch BY, et al. Emergence of four cases of KPC-2 and KPC-3-carrying Klebsiella pneumoniae introduced to Switzerland, 2009–10. Euro Surveill. 2011;16. pii: 19817.
10.
go back to reference Witteck A, Rettenmund G, Schlegel M. MRSA admission screening in a low prevalence setting—much ado about nothing? Swiss Med Wkly. 2011;141:w13217.PubMed Witteck A, Rettenmund G, Schlegel M. MRSA admission screening in a low prevalence setting—much ado about nothing? Swiss Med Wkly. 2011;141:w13217.PubMed
11.
go back to reference Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA. Manual of clinical microbiology. 9th ed. Washington, DC: ASM Press; 2007. Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA. Manual of clinical microbiology. 9th ed. Washington, DC: ASM Press; 2007.
12.
go back to reference Isenberg HD. Clinical microbiology procedures handbook. 2nd ed. Washington, DC: ASM Press; 2004. Isenberg HD. Clinical microbiology procedures handbook. 2nd ed. Washington, DC: ASM Press; 2004.
13.
go back to reference Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twenty-second informational supplement (M100-S22). CLSI, Wayne, PA; 2012. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twenty-second informational supplement (M100-S22). CLSI, Wayne, PA; 2012.
14.
go back to reference Babouee B, Frei R, Schultheiss E, Widmer AF, Goldenberger D. Comparison of the DiversiLab repetitive element PCR system with spa typing and pulsed-field gel electrophoresis for clonal characterization of methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 2011;49:1549–55.PubMedCentralPubMedCrossRef Babouee B, Frei R, Schultheiss E, Widmer AF, Goldenberger D. Comparison of the DiversiLab repetitive element PCR system with spa typing and pulsed-field gel electrophoresis for clonal characterization of methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 2011;49:1549–55.PubMedCentralPubMedCrossRef
17.
go back to reference Akova M, Daikos GL, Tzouvelekis L, Carmeli Y. Interventional strategies and current clinical experience with carbapenemase-producing Gram-negative bacteria. Clin Microbiol Infect. 2012;18:439–48.PubMedCrossRef Akova M, Daikos GL, Tzouvelekis L, Carmeli Y. Interventional strategies and current clinical experience with carbapenemase-producing Gram-negative bacteria. Clin Microbiol Infect. 2012;18:439–48.PubMedCrossRef
18.
go back to reference Miriagou V, Cornaglia G, Edelstein M, Galani I, Giske CG, Gniadkowski M, et al. Acquired carbapenemases in Gram-negative bacterial pathogens: detection and surveillance issues. Clin Microbiol Infect. 2010;16:112–22.PubMedCrossRef Miriagou V, Cornaglia G, Edelstein M, Galani I, Giske CG, Gniadkowski M, et al. Acquired carbapenemases in Gram-negative bacterial pathogens: detection and surveillance issues. Clin Microbiol Infect. 2010;16:112–22.PubMedCrossRef
19.
go back to reference Hotchkiss RS, Monneret G, Payen D. Immunosuppression in sepsis: a novel understanding of the disorder and a new therapeutic approach. Lancet Infect Dis. 2013;13:260–8.PubMedCentralPubMedCrossRef Hotchkiss RS, Monneret G, Payen D. Immunosuppression in sepsis: a novel understanding of the disorder and a new therapeutic approach. Lancet Infect Dis. 2013;13:260–8.PubMedCentralPubMedCrossRef
20.
go back to reference Aubron C, Cheng AC, Pilcher D, Leong T, Magrin G, Cooper DJ, et al. Infections acquired by adults who receive extracorporeal membrane oxygenation: risk factors and outcome. Infect Control Hosp Epidemiol. 2013;34:24–30.PubMedCrossRef Aubron C, Cheng AC, Pilcher D, Leong T, Magrin G, Cooper DJ, et al. Infections acquired by adults who receive extracorporeal membrane oxygenation: risk factors and outcome. Infect Control Hosp Epidemiol. 2013;34:24–30.PubMedCrossRef
21.
go back to reference Jernigan MG, Press EG, Nguyen MH, Clancy CJ, Shields RK. The combination of doripenem and colistin is bactericidal and synergistic against colistin-resistant, carbapenemase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother. 2012;56:3395–8.PubMedCentralPubMedCrossRef Jernigan MG, Press EG, Nguyen MH, Clancy CJ, Shields RK. The combination of doripenem and colistin is bactericidal and synergistic against colistin-resistant, carbapenemase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother. 2012;56:3395–8.PubMedCentralPubMedCrossRef
22.
go back to reference Le J, McKee B, Srisupha-Olarn W, Burgess DS. In vitro activity of carbapenems alone and in combination with amikacin against KPC-producing Klebsiella pneumoniae. J Clin Med Res. 2011;3:106–10.PubMedCentralPubMed Le J, McKee B, Srisupha-Olarn W, Burgess DS. In vitro activity of carbapenems alone and in combination with amikacin against KPC-producing Klebsiella pneumoniae. J Clin Med Res. 2011;3:106–10.PubMedCentralPubMed
23.
go back to reference Tumbarello M, Viale P, Viscoli C, Trecarichi EM, Tumietto F, Marchese A, et al. Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: importance of combination therapy. Clin Infect Dis. 2012;55:943–50.PubMedCrossRef Tumbarello M, Viale P, Viscoli C, Trecarichi EM, Tumietto F, Marchese A, et al. Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: importance of combination therapy. Clin Infect Dis. 2012;55:943–50.PubMedCrossRef
24.
go back to reference Lee GC, Burgess DS. Treatment of Klebsiella pneumoniae carbapenemase (KPC) infections: a review of published case series and case reports. Ann Clin Microbiol Antimicrob. 2012;11:32.PubMedCentralPubMedCrossRef Lee GC, Burgess DS. Treatment of Klebsiella pneumoniae carbapenemase (KPC) infections: a review of published case series and case reports. Ann Clin Microbiol Antimicrob. 2012;11:32.PubMedCentralPubMedCrossRef
25.
go back to reference Qureshi ZA, Paterson DL, Potoski BA, Kilayko MC, Sandovsky G, Sordillo E, et al. Treatment outcome of bacteremia due to KPC-producing Klebsiella pneumoniae: superiority of combination antimicrobial regimens. Antimicrob Agents Chemother. 2012;56:2108–13.PubMedCentralPubMedCrossRef Qureshi ZA, Paterson DL, Potoski BA, Kilayko MC, Sandovsky G, Sordillo E, et al. Treatment outcome of bacteremia due to KPC-producing Klebsiella pneumoniae: superiority of combination antimicrobial regimens. Antimicrob Agents Chemother. 2012;56:2108–13.PubMedCentralPubMedCrossRef
26.
go back to reference Matthaiou DK, Michalopoulos A, Rafailidis PI, Karageorgopoulos DE, Papaioannou V, Ntani G, et al. Risk factors associated with the isolation of colistin-resistant gram-negative bacteria: a matched case–control study. Crit Care Med. 2008;36:807–11.PubMedCrossRef Matthaiou DK, Michalopoulos A, Rafailidis PI, Karageorgopoulos DE, Papaioannou V, Ntani G, et al. Risk factors associated with the isolation of colistin-resistant gram-negative bacteria: a matched case–control study. Crit Care Med. 2008;36:807–11.PubMedCrossRef
Metadata
Title
First documented outbreak of KPC-2-producing Klebsiella pneumoniae in Switzerland: infection control measures and clinical management
Authors
E. Lemmenmeier
P. Kohler
T. Bruderer
D. Goldenberger
G.-R. Kleger
M. Schlegel
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 3/2014
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-013-0578-9

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