emergence of kpc-producing klebsiella pneumoniae in uruguay: infection control and molecular characterization

Clicks: 198
ID: 149334
2014
We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (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 kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination.
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Authors ;C. Marquez;A. Ingold;N. Echeverría;A. Acevedo;R. Vignoli;V. García-Fulgueiras;J. Viroga;O. Gonzalez;V. Odizzio;K. Etulain;E. Nuñez;H. Albornoz;G. Borthagaray;A. Galiana
Journal rasprave: Časopis instituta za hrvatski jezik i jezikoslovlje
Year 2014
DOI 10.1002/nmi2.40
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