Rapid molecular technique analysis of a KPC-3-producing Klebsiella pneumoniae outbreak in an Italian surgery unit

J Chemother. 2012 Apr;24(2):93-6. doi: 10.1179/1120009X12Z.00000000020.

Abstract

The rapid emergence of KPC-producing Klebsiella pneumoniae has become a serious problem in health-care settings, increasing in frequency worldwide. These infections are worrisome, since the antimicrobial treatment options for infections due to multidrug-resistant strains are very limited, and outbreaks must be rapidly detected and controlled. A semi-automated, repetitive-sequence-based PCR (rep-PCR) instrument (DiversiLab system) was evaluated in comparison with the pulse-field gel electrophoresis (PFGE) and multilocus sequence typing to investigate the outbreak of KPC-producing K. pneumoniae in a surgery unit at the University Hospital of Verona, Italy, as a rapid method for outbreak investigations. A selection of seven epidemiologically related K. pneumoniae showing resistance to carbapenem and three epidemiologically unrelated K. pneumoniae isolates were collected from patient with hospital-acquired infection. Among the epidemiologically related isolates, PFGE and Rep-PCR identified a unique pattern with more than 90% of homology. The concordance between DiversiLab and PFGE results confirmed the usefulness of rapid molecular techniques to investigate outbreaks due to multidrug-resistant bacteria. Moreover, this result could meet the international need for a harmonised typing tool, allowing the implementation of strict control measures to prevent dissemination of these organisms in health-care settings.

MeSH terms

  • Abdomen / microbiology*
  • Abdomen / surgery*
  • Bacterial Proteins / genetics*
  • Bacterial Typing Techniques
  • DNA, Bacterial / genetics
  • Disease Outbreaks*
  • Electrophoresis, Gel, Pulsed-Field
  • Hospitals, University
  • Humans
  • Italy
  • Klebsiella Infections / diagnosis*
  • Klebsiella Infections / genetics
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification*
  • Microbial Sensitivity Tests
  • Multilocus Sequence Typing
  • Polymerase Chain Reaction
  • Repetitive Sequences, Nucleic Acid / genetics
  • beta-Lactamases / genetics*

Substances

  • Bacterial Proteins
  • DNA, Bacterial
  • beta-Lactamases
  • beta-lactamase KPC-3, Klebsiella pneumoniae