Epidemiological and Microbiological Characteristics of an Outbreak Caused by OXA-48-Producing Enterobacteriaceae in a Neonatal Intensive Care Unit in Jerusalem, Israel
- 1 September 2013
- journal article
- Published by American Society for Microbiology in Journal of Clinical Microbiology
- Vol. 51 (9), 2926-2930
- https://doi.org/10.1128/jcm.01049-13
Abstract
This study describes the course of an OXA-48-producing Enterobacteriaceae (OPE) outbreak that started in March 2012 in a neonatal intensive care unit (NICU) in Jerusalem, Israel. During the peak of the outbreak (January to August 2012), there were 49 patients who had proven or suspected acquisition of OPE in the NICU, including 16 with invasive infections, out of a total of 156 patients who were hospitalized during that period. Three children hospitalized in the pediatric ICU were identified as carriers of OPE. Three patients with a previous stay in the affected NICU were identified as OPE carriers upon admission to another hospital. The Ministry of Health was notified and then intervened in July 2012. Intervention included cohorting colonized patients, conducting frequent rectal-culture surveillance, and improving the implementation of infection control practices. As a result, the incidence of OPE acquisition declined to 5 cases in the first 4 months, followed by no new cases in the next 3 months. Thirty-one patient-unique isolates were available for analysis: 29 Klebsiella pneumoniae isolates, all belonging to a single clone (sequence type 39 [ST39]), and 2 isolates from Enterobacter cloacae . All isolates possessed the bla OXA-48 and bla CTX-M-14 genes, which are located on the same plasmid. This plasmid, similar to the global bla OXA-48 -harboring vector, has now acquired bla CTX-M-14 , leading to resistance to all β-lactam agents.Keywords
This publication has 24 references indexed in Scilit:
- Carbapenemases in Klebsiella pneumoniae and Other Enterobacteriaceae: an Evolving Crisis of Global DimensionsClinical Microbiology Reviews, 2012
- Introduction of OXA-48-producing Enterobacteriaceae to Israeli hospitals by medical tourismJournal of Antimicrobial Chemotherapy, 2011
- Outbreak of OXA-48-Positive Carbapenem-Resistant Klebsiella pneumoniae Isolates in FranceAntimicrobial Agents and Chemotherapy, 2011
- A sensitive and specific phenotypic assay for detection of metallo-β-lactamases and KPC in Klebsiella pneumoniae with the use of meropenem disks supplemented with aminophenylboronic acid, dipicolinic acid and cloxacillinClinical Microbiology & Infection, 2011
- Containment of a Country-wide Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in Israeli Hospitals via a Nationally Implemented InterventionClinical Infectious Diseases, 2011
- Molecular Epidemiology, Sequence Types, and Plasmid Analyses of KPC-Producing Klebsiella pneumoniae Strains in IsraelAntimicrobial Agents and Chemotherapy, 2010
- Transfer of Carbapenem-Resistant Plasmid fromKlebsiella pneumoniaeST258 toEscherichia coliin PatientEmerging Infectious Diseases, 2010
- Spread of OXA-48-mediated resistance to carbapenems in LebaneseKlebsiellapneumoniaeandEscherichiacolithat produce extended spectrum β-lactamasePathogens and Global Health, 2010
- ISfinder: the reference centre for bacterial insertion sequencesNucleic Acids Research, 2006
- Extended-Spectrum β-Lactamases: a Clinical UpdateClinical Microbiology Reviews, 2005