Emergence of KPC‐producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization. Issue 3 (4th April 2014)

• Record Type: Journal Article
• Authors: Marquez, C.; Ingold, A.; Echeverría, N.; Acevedo, A.; Vignoli, R.; García‐Fulgueiras, V.; Viroga, J.; Gonzalez, O.; Odizzio, V.; Etulain, K.; Nuñez, E.; Albornoz, H.; Borthagaray, G.; Galiana, A.
• Is Part Of: New microbes and new infections. Volume 2:Issue 3(2014)
• Page Start: 58
• Page End: 63
• Publication Date: 2014-04-04
• Subjects: Medical microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; Microbiology -- Periodicals; Communicable Diseases -- Periodicals; Infection -- Periodicals; 616.9041
• DOI: 10.1002/nmi2.40
• Languages: English
• ISSNs: 2052-2975

Abstract

<abstract abstract-type="main" id="nmi240-abs-0001"> <title>Abstract</title> <p>We describe the first outbreak of <italic>Klebsiella pneumoniae</italic> carbapenemase‐producing <italic>K. pneumoniae</italic> (KPC‐KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC‐KP strain exhibited a multiresistant antibiotic phenotype including co‐resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β‐lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC‐KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low‐level resistance KPC‐KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The <italic>kpc</italic> gene was inserted in a Tn<italic>4401</italic> isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination.</p> </abstract>