Evidence of Interhospital Transmission of Extended-Spectrum β-Lactam-Resistant Klebsiella pneumoniae in the United States, 1986 to 1993
| Autor: | Fred C. Tenover, David H. Culver, Edwards, James S. Tolson, Robert P. Gaynes, James W. Biddle, William J. Martone, D L Monnet |
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| Rok vydání: | 1997 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Cefotaxime biology Epidemiology Klebsiella pneumoniae business.industry Outbreak Ceftazidime Aztreonam biology.organism_classification Microbiology chemistry.chemical_compound Infectious Diseases Antibiotic resistance chemistry Internal medicine medicine Pulsed-field gel electrophoresis Ceftriaxone business medicine.drug |
| Zdroj: | Infection Control and Hospital Epidemiology. 18:492-498 |
| ISSN: | 1559-6834 0899-823X |
| Popis: | Background: In addition to single-hospital outbreaks, interhospital transmission of extended-spectrum β-lactam-resistant (ESBLR) Klebsiella pneumoniae has been suspected in some reports. However, these studies lacked sufficient epidemiological information to confirm such an occurrence. Methods: We reviewed the surveillance data reported to the National Nosocomial Infections Surveillance (NNIS) System during 1986 to 1993 for K pneumoniae isolates and their susceptibility to either ceftazidime, cefotaxime, ceftriaxone, or aztreonam. Pulsed-field gel electrophoresis (PFGE) was used to study available ESBLR K pneumoniae isolates. Results: Among 8,319 K pneumoniae isolates associated with nosocomial infections, 727 (8.7%) were resistant or had intermediate-level resistance to at least one of these antibiotics. One hospital (hospital A) accounted for 321 isolates (44.2%) of ESBLR K pneumoniae . During 1986 to 1993, the percentage of K pneumoniae isolates that were ESBLR increased from 0 to 57.7% in hospital A, from 0 to 35.6% in NNIS hospitals 0 to 20 miles from hospital A (area B), and from 1.6 to 7.3% in NNIS hospitals more than 20 miles from hospital A, including hospitals located throughout the United States. Analysis of PFGE restriction profiles showed a genetic relationship between a cluster of isolates from hospital A and some isolates from one hospital in area B, and consecutive admission in these two hospitals was confirmed for two patients from whom isolates were available. Conclusions: These data provide evidence of interhospital transmission of ESBLR K pneumoniae in one region of the United States and stress the interrelationship between hospitals when trying to control antimicrobial resistance. |
| Databáze: | OpenAIRE |
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