Abstract
BackgroundAlthough the presence of Carbapenemase-producing Enterobacteriaceae (CPE) are extensively documented in North and South America. CPE have not been reported from Curacao. However, recently intercontinental spread was suggested of a KPC carbapenemase producing Klebsiella pneumoniae in a patient in the United Kingdom with previous admission to a hospital in Curacao in 2009.FindingsAfter the introduction of the CLSI 2010 revised breakpoints, seven patients with carbapenemase-producing Enterobacteriaceae were found in a general hospital in Curacao over a period of 16 months. Four patients carried KPC-2 positive Klebsiella pneumoniae, ST11. Two patients carried KPC-3 positive Klebsiella pneumoniae ST258 and one patient carried a KPC-3 positive Citrobacter freundii. Furthermore, our Klebsiella pneumoniae KPC-2 ST11 strain was matched to the Klebsiella pneumoniae KPC-2 ST11 strain in the United Kingdom.ConclusionsIntroduction of new laboratory methods, and adoption of new guidelines and breakpoints led to the first detection of CPE in Curacao. By matching our Klebsiella pneumoniae KPC-2 ST11 strain to a Klebsiella pneumoniae KPC-2 ST11 strain in the United Kingdom, we suggest that carbapenemase-producing Enterobacteriaceae are probably more prevalent in Curacao than previously recognized.
Highlights
The presence of Carbapenemase-producing Enterobacteriaceae (CPE) are extensively documented in North and South America
By matching our Klebsiella pneumoniae KPC-2 ST11 strain to a Klebsiella pneumoniae KPC-2 ST11 strain in the United Kingdom, we suggest that carbapenemase-producing Enterobacteriaceae are probably more prevalent in Curacao than previously recognized
Until 2010 no CPE had been reported in Curacao, intercontinental spread was suggested in a report of a KPC-producing Klebsiella pneumoniae isolated from a patient in the United Kingdom who had travelled to Curacao in 2009 [4]
Summary
Introduction of new laboratory methods, and adoption of new guidelines and breakpoints led to the first detection of CPE in Curacao. By matching our Klebsiella pneumoniae KPC-2 ST11 strain to a Klebsiella pneumoniae KPC-2 ST11 strain in the United Kingdom, we suggest that carbapenemase-producing Enterobacteriaceae are probably more prevalent in Curacao than previously recognized. Findings Infections with carbapenemase-producing Enterobacteriaceae (CPE) present clinicians with serious treatment challenges due to limited antibiotic options. They have been associated with high rates of mortality and morbidity, in patients with severe underlying illnesses. Until 2010 no CPE had been reported in Curacao, intercontinental spread was suggested in a report of a KPC-producing Klebsiella pneumoniae isolated from a patient in the United Kingdom who had travelled to Curacao in 2009 [4].
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