Outbreak of KPC-producing Klebsiella pneumoniae at a Portuguese university hospital : Epidemiological characterization and containment measures
Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of PBJ-Associação Porto Biomedical/Porto Biomedical Society. All rights reserved..
Background: KPC-producing K pneumoniae (KPC-Kp) is a public health problem with important clinical and epidemiological implications. We describe an outbreak of KPC-Kp at vascular surgery and neurosurgery wards in a central hospital in Porto, Portugal.
Methods: A case of KPC-Kp was considered to be a patient positive for KPC-Kp with strong epidemiological plausibility of having acquired this microorganism in the affected wards and/or with genetic relationship ≥92% between KPC-Kp isolates. Active surveillance cultures (ASCs) and real-time polymerase chain reaction were used for the detection of carbapenemase genes through rectal swab in a selected population. Molecular analysis was performed using pulsed-field gel electrophoresis at the National Reference Laboratory. Patient risk factors were collected from the electronic medical record system. Information regarding outbreak containment strategy was collected from the Infection Control Unit records.
Results: Of the 16 cases, 11 (69%) were identified through active screening, representing 1.4% of the total 766 ASCs collected. The most frequent risk factors identified were previous admission (63%), antibiotic exposure in the past 6 months (50%), and immunodepression (44%). The length of stay until KPC-Kp detection was high (0-121 days, mean 35.6), as was the total length of stay (5-173 days, mean 56.6). Three patients (19%) were infected by KPC-Kp, 2 of whom died. One previously colonized patient died later because of KPC-Kp infection.
Conclusions: Multifactorial strategy based on contact precautions (with patient and healthcare professional cohorts) and ASC, as well as Antibiotic Stewardship Program reinforcement, allowed to contain this KPC-Kp outbreak.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
Porto biomedical journal - 7(2022), 6 vom: 01. Nov., Seite e186 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Peres, David [VerfasserIn] |
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| Links: |
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| Themen: |
Active surveillance cultures |
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| Anmerkungen: |
Date Revised 09.05.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1097/j.pbj.0000000000000186 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM356552292 |
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| 245 | 1 | 0 | |a Outbreak of KPC-producing Klebsiella pneumoniae at a Portuguese university hospital |b Epidemiological characterization and containment measures |
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| 520 | |a Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of PBJ-Associação Porto Biomedical/Porto Biomedical Society. All rights reserved. | ||
| 520 | |a Background: KPC-producing K pneumoniae (KPC-Kp) is a public health problem with important clinical and epidemiological implications. We describe an outbreak of KPC-Kp at vascular surgery and neurosurgery wards in a central hospital in Porto, Portugal | ||
| 520 | |a Methods: A case of KPC-Kp was considered to be a patient positive for KPC-Kp with strong epidemiological plausibility of having acquired this microorganism in the affected wards and/or with genetic relationship ≥92% between KPC-Kp isolates. Active surveillance cultures (ASCs) and real-time polymerase chain reaction were used for the detection of carbapenemase genes through rectal swab in a selected population. Molecular analysis was performed using pulsed-field gel electrophoresis at the National Reference Laboratory. Patient risk factors were collected from the electronic medical record system. Information regarding outbreak containment strategy was collected from the Infection Control Unit records | ||
| 520 | |a Results: Of the 16 cases, 11 (69%) were identified through active screening, representing 1.4% of the total 766 ASCs collected. The most frequent risk factors identified were previous admission (63%), antibiotic exposure in the past 6 months (50%), and immunodepression (44%). The length of stay until KPC-Kp detection was high (0-121 days, mean 35.6), as was the total length of stay (5-173 days, mean 56.6). Three patients (19%) were infected by KPC-Kp, 2 of whom died. One previously colonized patient died later because of KPC-Kp infection | ||
| 520 | |a Conclusions: Multifactorial strategy based on contact precautions (with patient and healthcare professional cohorts) and ASC, as well as Antibiotic Stewardship Program reinforcement, allowed to contain this KPC-Kp outbreak | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a KPC-producing K pneumoniae | |
| 650 | 4 | |a active surveillance cultures | |
| 650 | 4 | |a antimicrobial resistance | |
| 650 | 4 | |a carbapenemase-producing Enterobacteriaceae | |
| 650 | 4 | |a contact precautions | |
| 650 | 4 | |a outbreak | |
| 700 | 1 | |a Figueiredo, Paulo |e verfasserin |4 aut | |
| 700 | 1 | |a Andrade, Paulo |e verfasserin |4 aut | |
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| 700 | 1 | |a Duro, Raquel |e verfasserin |4 aut | |
| 700 | 1 | |a Dias, Arnaldo |e verfasserin |4 aut | |
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