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An outbreak of CTX-M-15-producing Klebsiella pneumoniae isolates in an intensive care unit of a teaching hospital in Kuwait.
Indian J Med Microbiol. 2011 Apr-Jun; 29(2):130-5.IJ

Abstract

OBJECTIVE

This study reports an outbreak of Klebsiella pneumoniae infections in 14 patients during a 2-month period (August-September, 2008) in the intensive care unit (ICU) of a teaching hospital in Kuwait.

MATERIALS AND METHODS

The clinical sources were blood (9), urine (3) and respiratory secretions (2) identified by the automated VITEK-2 ID System. Susceptibility testing was performed by the E-test method. Extended-spectrum β-lactamase (ESBL) production was assessed using the ESBL E-test and confirmed by PCR. Carriage of bla genes was determined by PCR and sequence analysis. The transferability of resistance phenotypes was demonstrated by conjugation experiments and clonal relatedness was determined by PFGE.

RESULTS

The isolates were susceptible to imipenem, meropenem, and tigecycline and produced ESBL. All isolates yielded an amplicon of 499 bp with universal consensus primers (MA primers). DNA sequence analysis showed that they all harboured bla CTX-M-15 and bla TEM-1 genes. The environmental isolate obtained from a suction machine was also CTX-M-15/TEM-1 producer. The resistance phenotypes were transferrable to the Escherichia coli J53 r strain. PFGE, revealed two clones, A and B, related with a Dice coefficient of >94.1%. A mortality rate of 21.4% was recorded.

CONCLUSION

The outbreak was contained by robust and aggressive infection control measures. This study highlights the first outbreak of CTX-M-15-producing K. pneumoniae associated with high mortality in an adult medical ICU in Kuwait.

Authors+Show Affiliations

Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, Safat 13110, Kuwait. nalsweih@hsc.edu.kwNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21654106

Citation

Al Sweih, N, et al. "An Outbreak of CTX-M-15-producing Klebsiella Pneumoniae Isolates in an Intensive Care Unit of a Teaching Hospital in Kuwait." Indian Journal of Medical Microbiology, vol. 29, no. 2, 2011, pp. 130-5.
Al Sweih N, Salama MF, Jamal W, et al. An outbreak of CTX-M-15-producing Klebsiella pneumoniae isolates in an intensive care unit of a teaching hospital in Kuwait. Indian J Med Microbiol. 2011;29(2):130-5.
Al Sweih, N., Salama, M. F., Jamal, W., Al Hashem, G., & Rotimi, V. O. (2011). An outbreak of CTX-M-15-producing Klebsiella pneumoniae isolates in an intensive care unit of a teaching hospital in Kuwait. Indian Journal of Medical Microbiology, 29(2), 130-5. https://doi.org/10.4103/0255-0857.81791
Al Sweih N, et al. An Outbreak of CTX-M-15-producing Klebsiella Pneumoniae Isolates in an Intensive Care Unit of a Teaching Hospital in Kuwait. Indian J Med Microbiol. 2011 Apr-Jun;29(2):130-5. PubMed PMID: 21654106.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An outbreak of CTX-M-15-producing Klebsiella pneumoniae isolates in an intensive care unit of a teaching hospital in Kuwait. AU - Al Sweih,N, AU - Salama,M F, AU - Jamal,W, AU - Al Hashem,G, AU - Rotimi,V O, PY - 2011/6/10/entrez PY - 2011/6/10/pubmed PY - 2011/9/29/medline SP - 130 EP - 5 JF - Indian journal of medical microbiology JO - Indian J Med Microbiol VL - 29 IS - 2 N2 - OBJECTIVE: This study reports an outbreak of Klebsiella pneumoniae infections in 14 patients during a 2-month period (August-September, 2008) in the intensive care unit (ICU) of a teaching hospital in Kuwait. MATERIALS AND METHODS: The clinical sources were blood (9), urine (3) and respiratory secretions (2) identified by the automated VITEK-2 ID System. Susceptibility testing was performed by the E-test method. Extended-spectrum β-lactamase (ESBL) production was assessed using the ESBL E-test and confirmed by PCR. Carriage of bla genes was determined by PCR and sequence analysis. The transferability of resistance phenotypes was demonstrated by conjugation experiments and clonal relatedness was determined by PFGE. RESULTS: The isolates were susceptible to imipenem, meropenem, and tigecycline and produced ESBL. All isolates yielded an amplicon of 499 bp with universal consensus primers (MA primers). DNA sequence analysis showed that they all harboured bla CTX-M-15 and bla TEM-1 genes. The environmental isolate obtained from a suction machine was also CTX-M-15/TEM-1 producer. The resistance phenotypes were transferrable to the Escherichia coli J53 r strain. PFGE, revealed two clones, A and B, related with a Dice coefficient of >94.1%. A mortality rate of 21.4% was recorded. CONCLUSION: The outbreak was contained by robust and aggressive infection control measures. This study highlights the first outbreak of CTX-M-15-producing K. pneumoniae associated with high mortality in an adult medical ICU in Kuwait. SN - 1998-3646 UR - https://www.unboundmedicine.com/medline/citation/21654106/An_outbreak_of_CTX_M_15_producing_Klebsiella_pneumoniae_isolates_in_an_intensive_care_unit_of_a_teaching_hospital_in_Kuwait_ L2 - http://www.ijmm.org/article.asp?issn=0255-0857;year=2011;volume=29;issue=2;spage=130;epage=135;aulast=Al DB - PRIME DP - Unbound Medicine ER -