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Cluster of bloodstream infections caused by KPC-2 carbapenemase-producing Klebsiella pneumoniae in Manhattan.
Am J Infect Control. 2009 Mar; 37(2):121-6.AJ

Abstract

BACKGROUND

Carbapenems are considered the agents of choice for treatment of serious infections caused by resistant gram-negative organisms. A new group of class A beta-lactamases, known as KPC-type carbapenemases, has recently been described and poses a serious clinical challenge.

METHODS

Seven patients with bloodstream infections caused by Klebsiella pneumoniae isolates with decreased susceptibility to carbapenems were identified between January and April 2005 in the intensive care units of a hospital in Manhattan. Isolate identification and susceptibility testing were performed according to National Committee for Clinical Laboratory Standards methodology. All isolates were ribotyped and screened for (bla)KPC by polymerase chain reaction. The polymerase chain reaction product underwent nucleotide sequencing for one of the isolates. Medical records were reviewed retrospectively.

RESULTS

Six isolates were carbapenem-resistant with minimum inhibitory concentrations for imipenem of >8microg/mL. Ribotyping showed that all isolates belonged to a single clone. All isolates possessed (bla)KPC and nucleotide sequencing identified the allelic type KPC-2. Patients' median age was 68 years. The median duration of hospitalization was 25.5 days before the first positive blood culture. Five of 6 patients received previous broad-spectrum beta-lactam antibiotics but none received prior carbapenems. Five of 6 isolates were susceptible to polymyxin B. Three of the 5 patients were treated with polymyxin B and 1 survived. Overall, only 2 of the 6 patients survived.

CONCLUSION

This report describes the first outbreak of KPC-2 carbapenemase-producing K pneumoniae bloodstream infections in a hospital in Manhattan.

Authors+Show Affiliations

Harlem Hospital Center, New York, NY, USA. abhin@lycos.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19249638

Citation

Nadkarni, Abhijeet S., et al. "Cluster of Bloodstream Infections Caused By KPC-2 Carbapenemase-producing Klebsiella Pneumoniae in Manhattan." American Journal of Infection Control, vol. 37, no. 2, 2009, pp. 121-6.
Nadkarni AS, Schliep T, Khan L, et al. Cluster of bloodstream infections caused by KPC-2 carbapenemase-producing Klebsiella pneumoniae in Manhattan. Am J Infect Control. 2009;37(2):121-6.
Nadkarni, A. S., Schliep, T., Khan, L., & Zeana, C. B. (2009). Cluster of bloodstream infections caused by KPC-2 carbapenemase-producing Klebsiella pneumoniae in Manhattan. American Journal of Infection Control, 37(2), 121-6. https://doi.org/10.1016/j.ajic.2007.10.013
Nadkarni AS, et al. Cluster of Bloodstream Infections Caused By KPC-2 Carbapenemase-producing Klebsiella Pneumoniae in Manhattan. Am J Infect Control. 2009;37(2):121-6. PubMed PMID: 19249638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cluster of bloodstream infections caused by KPC-2 carbapenemase-producing Klebsiella pneumoniae in Manhattan. AU - Nadkarni,Abhijeet S, AU - Schliep,Tjark, AU - Khan,Lamia, AU - Zeana,Cosmina B, PY - 2007/05/07/received PY - 2007/09/28/revised PY - 2007/10/02/accepted PY - 2009/3/3/entrez PY - 2009/3/3/pubmed PY - 2009/4/10/medline SP - 121 EP - 6 JF - American journal of infection control JO - Am J Infect Control VL - 37 IS - 2 N2 - BACKGROUND: Carbapenems are considered the agents of choice for treatment of serious infections caused by resistant gram-negative organisms. A new group of class A beta-lactamases, known as KPC-type carbapenemases, has recently been described and poses a serious clinical challenge. METHODS: Seven patients with bloodstream infections caused by Klebsiella pneumoniae isolates with decreased susceptibility to carbapenems were identified between January and April 2005 in the intensive care units of a hospital in Manhattan. Isolate identification and susceptibility testing were performed according to National Committee for Clinical Laboratory Standards methodology. All isolates were ribotyped and screened for (bla)KPC by polymerase chain reaction. The polymerase chain reaction product underwent nucleotide sequencing for one of the isolates. Medical records were reviewed retrospectively. RESULTS: Six isolates were carbapenem-resistant with minimum inhibitory concentrations for imipenem of >8microg/mL. Ribotyping showed that all isolates belonged to a single clone. All isolates possessed (bla)KPC and nucleotide sequencing identified the allelic type KPC-2. Patients' median age was 68 years. The median duration of hospitalization was 25.5 days before the first positive blood culture. Five of 6 patients received previous broad-spectrum beta-lactam antibiotics but none received prior carbapenems. Five of 6 isolates were susceptible to polymyxin B. Three of the 5 patients were treated with polymyxin B and 1 survived. Overall, only 2 of the 6 patients survived. CONCLUSION: This report describes the first outbreak of KPC-2 carbapenemase-producing K pneumoniae bloodstream infections in a hospital in Manhattan. SN - 1527-3296 UR - https://www.unboundmedicine.com/medline/citation/19249638/Cluster_of_bloodstream_infections_caused_by_KPC_2_carbapenemase_producing_Klebsiella_pneumoniae_in_Manhattan_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-6553(08)00045-X DB - PRIME DP - Unbound Medicine ER -