Outbreak of Imipenemase-1-Producing Carbapenem-Resistant Klebsiella pneumoniae in an Intensive Care Unit / 대한중환자의학회지
Korean Journal of Critical Care Medicine
; : 29-38, 2017.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-194703
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported.METHODS:
Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame.RESULTS:
During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions.CONCLUSIONS:
This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission.
Texto completo:
Disponível
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
/
Doenças Negligenciadas
/
ODS3 - Meta 3.3 Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
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ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Objetivo 8: Surtos, emergências e desastres
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Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
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Doenças Negligenciadas
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Zoonoses
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Resistência Antimicrobiana
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Pneumonía
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Outras Doenças Respiratórias
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Pneumonia
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Escarro
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Reação em Cadeia da Polimerase
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Surtos de Doenças
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Mortalidade
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Controle de Infecções
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Eletroforese em Gel de Campo Pulsado
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Cuidados Críticos
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Farmacorresistência Bacteriana
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Difusão
Tipo de estudo:
Guia de prática clínica
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Estudo prognóstico
Limite:
Idoso
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Humanos
/
Masculino
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Korean Journal of Critical Care Medicine
Ano de publicação:
2017
Tipo de documento:
Artigo