Preliminary study on prevalence and transmission route of Klebsiella pneumoniae carbapenemases-producing Klebsiella pneumoniae

Abstract

Objective To investigate the prevalence and transmission route of Klebsiella pneumoniae carbapenemases (KPC)-producing Klebsiella pneumoniae in Xinhua Hospital Affiliated to Shanghaijiao Tong University School of Medicine. Methods Carbapenem-resistant Klebsiella pneumoniae isolates from clinical samples were collected from Xinhua Hospital during January 2010 and December 2013. Vitek 2 Compact and disc diffusion method (Kirby-Bauer method) were used for identification of the strains and antibiotic susceptibility test. Modified Hodge test was performed for drug-resistant phenotype screening. Carbapenemase gene blaKPC was amplified by PCR, and the positive products were sequenced and analyzed. Enterobacterial repetitive intergenic consensus(ERIC)-PCR was used to analyze molecular epidemiology of the KPC-producing strains. And clinical information of these isolates was analyzed. Results There were 77 carbapenem-resistant Klebsiella pneumoniae isolates in total, and 71 of them were positive in modified Hodge test. Sixty-nine isolates were identified carrying blaKPC-2 gene. All of the KPC-2-producing isolates were classified as the same genotype by ERIC-PCR. Among 12 patients with KPC-2-producing Klebsiella pneumoniae infection who were first identified in each departments, 7 were transferred from other departments, and 4 were treated in surgery intensive care unit (SICU). Conclusions Most of carbpenem-resistant Klebsiella pneumoniae strains isolated from Xinhua Hospital are KPC-2-producing. The outbreak of carbpenem-resistant Klebsiella pneumoniae infection in the hospital may be associated with the interdepartmental transfer of patients. Key words: Klebsiella pneumoniae; Klebsiella pneumoniae carbapenemases; Cross infection; Transmission routes