Abstract
Background:Since 2001 there have been several reported outbreaks due to carbapenem-resistant Klebsiella pneumoniae (Kp), particularly in the northeastern states.Methods:Carbapenemase-producing Enterobacteriaceae from healthcare facilities in Northeast Florida were phenotypically identified and confirmed using PCR amplification and sequencing of the blaKPC gene.Results:Results from PFGE analysis of these isolates demonstrated possible horizontal spread from two possible “outbreak” strains during the study period.Conclusions:We present the first published cluster of Kp and Escherichia coli (Ec) cases in Florida carrying the KPC-2 or KPC-3 gene.
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References
References1. Siegel JD, Rinehart E, Jackson M, et al. The Healthcare Infection Control Practices Advisory Committee. Management of multidrug-resistant organisms in healthcare settings. 2006. Available at: http://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf Accessed 18 December 2008.2. Yigit H, Queenan AM, Anderson GJ, et al. Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 2001;45:1151–1161.YigitH]]QueenanAM]]AndersonGJ&etal;Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae.Antimicrob Agents Chemother2001451151-11613. Smith Moland E, Hanson ND, Herrera VL, et al. Plasmid-mediated, carbapenem-hydrolyzing beta-lactamase, KPC-2 in Klebsiella pneumoniae isolates. J Antimicrob Chemother 2003;51:711–714.Smith MolandE]]HansonND]]HerreraVL&etal;Plasmid-mediated, carbapenem-hydrolyzing beta-lactamase, KPC-2 in Klebsiella pneumoniae isolates.J Antimicrob Chemother200351711-7144. Yigit H, Queenan AM, Anderson GJ, et al. Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 2008;52:809.YigitH]]QueenanAM]]AndersonGJ&etal;Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae.Antimicrob Agents Chemother2008528095. Woodford N, Tierno PM Jr, Young K, et al. Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York medical center. Antimicrob Agents Chemother 2004;48:4793–4799.WoodfordN]]TiernoPMJr]]YoungK&etal;Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York medical center.Antimicrob Agents Chemother2004484793-47996. Bratu S, Mooty M, Nichani S, et al. Emergence of KPC-possessing Klebsiella pneumoniae in Brooklyn, New York: epidemiology and recommendations for detection. Antimicrob Agents Chemother 2005;49:3018–3020.BratuS]]MootyM]]NichaniS&etal;Emergence of KPC-possessing Klebsiella pneumoniae in Brooklyn, New York: epidemiology and recommendations for detection.Antimicrob Agents Chemother2005493018-30207. Lee K, Chong Y, Shin HB, et al. Modified Hodge and EDTA-disk synergy tests to screen metallo-B-lactamase-producing strains of Pseudomonas and Acinetobacter species. Clin Microbiol Infect 2001;7:88–91.LeeK]]ChongY]]ShinHB&etal;Modified Hodge and EDTA-disk synergy tests to screen metallo-B-lactamase-producing strains of Pseudomonas and Acinetobacter species.Clin Microbiol Infect2001788-918. Tenover FC, Arbeit RD, Goering RV, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233–2239.TenoverFC]]ArbeitRD]]GoeringRV&etal;Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing.J Clin Microbiol1995332233-22399. Anderson KF, Lonsway DR, Rasheed JK, et al. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae. J Clin Microbiol 2007;45:2723–2725.AndersonKF]]LonswayDR]]RasheedJK&etal;Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae.J Clin Microbiol2007452723-272510. Deshpande LM, Rhomberg PR, Sader HS, et al. Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States medical centers: report from the MYSTIC program (1999–2005). Diagn Microbiol Infect Dis 2006;56:367–372.DeshpandeLM]]RhombergPR]]SaderHS&etal;Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States medical centers: report from the MYSTIC program (1999–2005).Diagn Microbiol Infect Dis200656367-37211. Moland ES, Soo-Young K, Hong SG, et al. Newer B-Lactamases: clinical and laboratory implications, Part II. Clin Microbial News 2008;30:79–85.MolandES]]Soo-YoungK]]HongSG&etal;Newer B-Lactamases: clinical and laboratory implications, Part II.Clin Microbial News20083079-8512. Navon-Venezia S, Chmelnitsky I, Leavitt A, et al. Plasmid-mediated imipenem-hydrolyzing enzyme KPC-2 among multiple carbapenem-resistant Escherichia coli clones in Israel. Antimicrob Agents Chemother 2006;50:3098–3101.Navon-VeneziaS]]ChmelnitskyI]]LeavittA&etal;Plasmid-mediated imipenem-hydrolyzing enzyme KPC-2 among multiple carbapenem-resistant Escherichia coli clones in Israel.Antimicrob Agents Chemother2006503098-310113. Bratu S, Landman D, Haag R, et al. Rapid spread of carbapenem-resistant Klebsiella pneumoniae in New York City: a new threat to our antibiotic armamentarium. Arch Intern Med 2005;165:1430–1435.BratuS]]LandmanD]]HaagR&etal;Rapid spread of carbapenem-resistant Klebsiella pneumoniae in New York City: a new threat to our antibiotic armamentarium.Arch Intern Med20051651430-143514. Bratu S, Tolaney P, Karumudi U, et al. Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY: molecular epidemiology and in vitro activity of polymyxin B and other agents. J Antimicrob Chemother 2005;56:128–132.BratuS]]TolaneyP]]KarumudiU&etal;Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY: molecular epidemiology and in vitro activity of polymyxin B and other agents.J Antimicrob Chemother200556128-13215. Pope J, Adams J, Doi Y. KPC type beta-lactamase, rural Pennsylvania. Emerg Infect Dis 2006;12:1613–1614.PopeJ]]AdamsJ]]DoiYKPC type beta-lactamase, rural Pennsylvania.Emerg Infect Dis2006121613-161416. Clinical and Laboratory Standards Institute. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Nineteenth Informational Supplement. Wayne, PA, Clinical and Laboratory Standards Institute, M100-S19, January, 2009.17. Tenover FC, Kalsi RK, Williams PP, et al. Carbapenem resistance in Klebsiella pneumoniae not detected by automated susceptibility testing. Emerg Infect Dis 2006;12:1209–1213.TenoverFC]]KalsiRK]]WilliamsPP&etal;Carbapenem resistance in Klebsiella pneumoniae not detected by automated susceptibility testing.Emerg Infect Dis2006121209-1213
