Abstract
Infection prevention and control measures are used to contain outbreaks of carbapenemase-producing Enterobacteriaceae. We report the absence of transmission of Klebsiella pneumoniae carrying New Delhi metallo-β-lactamase and oxacillinase-48 genes among 19 screened contacts of an index case after 14 months of routine practices in a long-term care facility.
Highlights
The emergence of carbapenem resistance among Gram negative bacteria heralds a future of potentially untreatable infections due to extreme antimicrobial resistance (Paterson and Doi, 2007)
This patient’s carbapenemase-producing Enterobacteriaceae (CPE) status was identified in the electronic patient record (EPR) to ensure that staff are aware of the need for additional infection control measures
During repeat acute hospital admissions in February 2018 and May 2019, two additional urine isolates from this same index case demonstrated the presence of K. pneumoniae containing both New Delhi metallo-β-lactamase (NDM) and OXA-48 carbapenemases
Summary
The emergence of carbapenem resistance among Gram negative bacteria heralds a future of potentially untreatable infections due to extreme antimicrobial resistance (Paterson and Doi, 2007). There are limited antimicrobial treatments existing for patients infected with these pathogens (Tacconelli et al, 2018). Infections due to CPE are associated with greater mortality than those caused by carbapenem-susceptible bacteria (Falagas et al, 2014). Canadian rates of CPE colonisation increased nearly five-fold from 2014 to 2017; an increase in the rate of CPE infection has not yet been documented in Canada (Public Health Agency of Canada, 2019). The implementation of institutional control measures is deemed essential to limit the spread of CPE locally, nationally and internationally (French et al, 2017; Public Health Agency of Canada, 2019)
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