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Open Access 01-12-2016 | Research article

Nosocomial outbreak of KPC-2- and NDM-1-producing Klebsiella pneumoniae in a neonatal ward: a retrospective study

Authors: Jing Yu, Kun Tan, Zhihui Rong, Yue Wang, Zhongju Chen, Xuhui Zhu, Li Wu, Li Tan, Wei Xiong, Ziyong Sun, Ling Chen

Published in: BMC Infectious Diseases | Issue 1/2016

Abstract

Background

The spread of resistance to carbapenems among Enterobacteriaceae has become a major public health problem in recent years. In this study, we describe an outbreak of Klebsiella pneumoniae in the neonatal ward. First, we aimed to study the drug resistance, genetic relatedness, and transmission mechanism of carbapenem-resistant K. pneumoniae; second, we implemented infection control measures to contain the outbreak.

Methods

We investigated 27 non-repetitive strains isolated from neonates and five strains cultured from around the neonatal ward. Polymerase chain reaction (PCR), the agar dilution method, and multilocus sequence typing (MLST) were used to analyze the resistance gene(s), antimicrobial susceptibility, and homology, respectively. Health-care personnel education, hand hygiene, outer gown changing, and infected patient isolation were strictly enforced.

Results

Our antimicrobial susceptibility results show that all strains were multidrug-resistant. MLST and PCR results revealed that, in this study, all of the KPC-2-producing strains are Sequence Type (ST) 11 (ST11) (n = 22) and all of the NDM-1-producing strains are ST20 (n = 4) or ST888 (n = 1). The environmental strains were identified as KPC-2-positive K. pneumoniae ST11 (n = 3) and NDM-1-positive K. pneumoniae ST20 (n = 2). The percentages of isolates with the extended-spectrum-β-lactamases CTX-M-15, blaCTX-M-14, blaTEM-1 were 9.4, 84.3, and 68.8 %, respectively. AmpC β-lactamase genes were not detected in our isolates.

Conclusions

KPC-2-positive K. pneumoniae ST11 and NDM-1-positive K. pneumoniae ST20 were associated with this outbreak. The identification of these isolates in samples from radiant warmers and nurses suggests that hospital cross-transmission played a role in this outbreak. Active infection control measures were effective for controlling this multidrug-resistant K. pneumoniae outbreak.

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Title: Nosocomial outbreak of KPC-2- and NDM-1-producing Klebsiella pneumoniae in a neonatal ward: a retrospective study
Authors: Jing Yu
Kun Tan
Zhihui Rong
Yue Wang
Zhongju Chen
Xuhui Zhu
Li Wu
Li Tan
Wei Xiong
Ziyong Sun
Ling Chen
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Infectious Diseases / Issue 1/2016
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-016-1870-y

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Conclusions

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