The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance

The worldwide dissemination of high-risk carbapenemase-producing Klebsiella pneumoniae clones has become a major threat to healthcare facilities. This study describes the successful containment of a hospital outbreak caused by NDM-1-producing K. pneumoniae Sequence Type (ST) 307 using active surveil...

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Autores principales: Bocanegra Ibarias, Paola, Garza González, Elvira, Padilla Orozco, Magaly, Mendoza Olazarán, Soraya Sarahí, Pérez Alba, Eduardo, Flores Treviño, Samantha Maribel, Garza Ramos, Ulises, Silva Sánchez, Jesús, Camacho Ortiz, Adrián
Formato: Artículo
Lenguaje:inglés
Publicado: Public Library of Science 2019
Acceso en línea:http://eprints.uanl.mx/15804/1/5.pdf
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author Bocanegra Ibarias, Paola
Garza González, Elvira
Padilla Orozco, Magaly
Mendoza Olazarán, Soraya Sarahí
Pérez Alba, Eduardo
Flores Treviño, Samantha Maribel
Garza Ramos, Ulises
Silva Sánchez, Jesús
Camacho Ortiz, Adrián
author_facet Bocanegra Ibarias, Paola
Garza González, Elvira
Padilla Orozco, Magaly
Mendoza Olazarán, Soraya Sarahí
Pérez Alba, Eduardo
Flores Treviño, Samantha Maribel
Garza Ramos, Ulises
Silva Sánchez, Jesús
Camacho Ortiz, Adrián
author_sort Bocanegra Ibarias, Paola
collection Repositorio Institucional
description The worldwide dissemination of high-risk carbapenemase-producing Klebsiella pneumoniae clones has become a major threat to healthcare facilities. This study describes the successful containment of a hospital outbreak caused by NDM-1-producing K. pneumoniae Sequence Type (ST) 307 using active surveillance. The outbreak began when a patient was transferred from a local hospital. After 48 hours in our hospital, a tracheal aspirate was positive for a meropenem resistant and carbapenemase-producing K. pneumoniae. All patients in the medical intensive care unit (ICU) and the neurology wards were subject to contact precautions. The hospital surfaces and devices, healthcare workers, and patients from these wards were screened by cultures. Fecal swabs were placed into broth and PCR for blaKPC, blaOXA-48, blaIMP, blaVIM, and blaNDM, which were performed directly from the broth after 12 hours. PCRs were also performed on DNA extracted from carbapenemase-producing species from subcultured broths. Five and nine days later, two more patients’ rectal swabs tested positive. Molecular assays identified K. pneumoniae blaNDM-1 onto a 130-kb conjugative plasmid (IncY, IncFIIs, and IncFIIY), ST307. After the three patients were discharged, monitoring continued, and after three weeks with negative results, rectal swabbing ended. In conclusion, it was possible to contain a hospital outbreak caused by NDM-1-producing K. pneumoniae ST307 through epidemiological and microbiological surveillance. With the methodology used, the detection of NDM-type genes in fecal samples was obtained in approximately 15 hours after obtaining the fecal sample.
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spelling eprints-158042020-06-10T20:00:17Z http://eprints.uanl.mx/15804/ The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance Bocanegra Ibarias, Paola Garza González, Elvira Padilla Orozco, Magaly Mendoza Olazarán, Soraya Sarahí Pérez Alba, Eduardo Flores Treviño, Samantha Maribel Garza Ramos, Ulises Silva Sánchez, Jesús Camacho Ortiz, Adrián The worldwide dissemination of high-risk carbapenemase-producing Klebsiella pneumoniae clones has become a major threat to healthcare facilities. This study describes the successful containment of a hospital outbreak caused by NDM-1-producing K. pneumoniae Sequence Type (ST) 307 using active surveillance. The outbreak began when a patient was transferred from a local hospital. After 48 hours in our hospital, a tracheal aspirate was positive for a meropenem resistant and carbapenemase-producing K. pneumoniae. All patients in the medical intensive care unit (ICU) and the neurology wards were subject to contact precautions. The hospital surfaces and devices, healthcare workers, and patients from these wards were screened by cultures. Fecal swabs were placed into broth and PCR for blaKPC, blaOXA-48, blaIMP, blaVIM, and blaNDM, which were performed directly from the broth after 12 hours. PCRs were also performed on DNA extracted from carbapenemase-producing species from subcultured broths. Five and nine days later, two more patients’ rectal swabs tested positive. Molecular assays identified K. pneumoniae blaNDM-1 onto a 130-kb conjugative plasmid (IncY, IncFIIs, and IncFIIY), ST307. After the three patients were discharged, monitoring continued, and after three weeks with negative results, rectal swabbing ended. In conclusion, it was possible to contain a hospital outbreak caused by NDM-1-producing K. pneumoniae ST307 through epidemiological and microbiological surveillance. With the methodology used, the detection of NDM-type genes in fecal samples was obtained in approximately 15 hours after obtaining the fecal sample. Public Library of Science 2019-02-13 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/15804/1/5.pdf http://eprints.uanl.mx/15804/1.haspreviewThumbnailVersion/5.pdf Bocanegra Ibarias, Paola y Garza González, Elvira y Padilla Orozco, Magaly y Mendoza Olazarán, Soraya Sarahí y Pérez Alba, Eduardo y Flores Treviño, Samantha Maribel y Garza Ramos, Ulises y Silva Sánchez, Jesús y Camacho Ortiz, Adrián (2019) The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance. PloS one, 14 (2). pp. 1-10. ISSN 1932-6203 doi:10.1371/journal.pone.0209609
spellingShingle Bocanegra Ibarias, Paola
Garza González, Elvira
Padilla Orozco, Magaly
Mendoza Olazarán, Soraya Sarahí
Pérez Alba, Eduardo
Flores Treviño, Samantha Maribel
Garza Ramos, Ulises
Silva Sánchez, Jesús
Camacho Ortiz, Adrián
The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance
thumbnail https://rediab.uanl.mx/themes/sandal5/images/online.png
title The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance
title_full The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance
title_fullStr The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance
title_full_unstemmed The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance
title_short The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance
title_sort successful containment of a hospital outbreak caused by ndm 1 producing klebsiella pneumoniae st307 using active surveillance
url http://eprints.uanl.mx/15804/1/5.pdf
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