Outbreak caused by multidrug-resistant OXA-48 and NDM-1 producing Klebsiella pneumoniae in the intensive care unit of a cancer hospital.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-08-29 Print Date: 2024-09-18 DOI:10.1556/030.2024.02364

Serap Süzük Yıldız, Esra Tavukcu, Sevgi Şahin, Gülşen İskender, Özlem Ünaldı, Buket Demirhan, Zuhal Avşar, Elif Özgür Orman, İpek Mumcuoğlu, Tuba Dal

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Abstract

We report a nosocomial outbreak caused by a multidrug-resistant carbapenemase-producing Klebsiella pneumoniae (MDRCPKp), that was detected in six patients admitted to the medical intensive care unit between 20th of December 2023 and 15th of January 2024 in Ankara, Turkey. The investigation of this outbreak was started on 29th of December 2023. During the outbreak 11 samples were collected from the six patients with MDRCPKp. Pulsed-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness and clonality of MDRCPKp strains. MDRCPKp was isolated in the tracheal aspiration culture, blood, urine, and screening samples. Five patients with MDRCPKp colonization developed healthcare-associated infection. In one patient MDRCPKp was isolated from tracheal aspirate and the screening cultures were considered as colonization not infection. PFGE analysis revealed that all isolates belonged to the same K. pneumoniae clone. MDRCPKp strain of this outbreak exhibited multidrug resistance and co-produced OXA-48 and NDM-1. This outbreak ended after application of strict infection control measures. An outbreak of MDRCPKp can occur in hospitals, especially in the intensive care units; thus, it should be detected early by infection control teams. A strong collaboration between infection control team and microbiology laboratory is essential to cope with MDR bacterial outbreaks in hospitals.

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一家癌症医院重症监护室爆发由产生耐多药 OXA-48 和 NDM-1 的肺炎克雷伯菌引起的疫情。

我们报告了 2023 年 12 月 20 日至 2024 年 1 月 15 日期间在土耳其安卡拉医疗重症监护室收治的六名患者中发现的由产多种耐药碳青霉烯酶肺炎克雷伯氏菌（MDRCPKp）引起的院内疫情。疫情调查始于 2023 年 12 月 29 日。疫情爆发期间，从六名 MDRCPKp 患者身上采集了 11 份样本。进行了脉冲场凝胶电泳（PFGE）以确定 MDRCPKp 菌株的遗传亲缘关系和克隆性。在气管抽吸培养物、血液、尿液和筛查样本中分离出了 MDRCPKp。五名有 MDRCPKp 定植的患者出现了医源性感染。一名患者从气管吸出物中分离出了 MDRCPKp，筛查培养结果被认为是定植而非感染。PFGE 分析显示，所有分离株都属于同一个肺炎克隆。此次疫情中的 MDRCPKp 菌株表现出多药耐药性，并可联合产生 OXA-48 和 NDM-1。在采取严格的感染控制措施后，疫情结束。MDRCPKp 可在医院爆发，尤其是在重症监护室；因此，感染控制小组应及早发现。感染控制小组与微生物实验室之间的紧密合作对于应对医院中 MDR 细菌的爆发至关重要。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.