Emergence of concurrent infections with colistin-resistant ESBL-positive Klebsiella pneumoniae and OXA-23-producing Acinetobacter baumannii sensitive to colistin only in a Romanian cardiac intensive care unit
| Autor: | M. Dan, E. Guguianu, Dorina Timofte, L. Ciucu, E. R. Dabija, Carmen Valentina Panzaru, Iuliana E Maciuca |
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| Rok vydání: | 2015 |
| Předmět: |
Microbiology (medical)
Acinetobacter baumannii Male medicine.medical_specialty Klebsiella pneumoniae Microbial Sensitivity Tests medicine.disease_cause law.invention Microbiology Medical microbiology law Drug Resistance Multiple Bacterial polycyclic compounds medicine Pulsed-field gel electrophoresis Humans Pseudomonas Infections Cross Infection biology Pseudomonas aeruginosa business.industry Colistin Romania General Medicine biochemical phenomena metabolism and nutrition bacterial infections and mycoses medicine.disease biology.organism_classification Intensive care unit Anti-Bacterial Agents Klebsiella Infections Pneumonia Intensive Care Units Infectious Diseases bacteria Female Cardiology Service Hospital business medicine.drug Acinetobacter Infections |
| Zdroj: | European journal of clinical microbiologyinfectious diseases : official publication of the European Society of Clinical Microbiology. 34(10) |
| ISSN: | 1435-4373 |
| Popis: | We report the emergence and analysis of a cluster of concurrent infections/colonisations with colistin-resistant Klebsiella pneumoniae and OXA-23 carbapenemase-producing Acinetobacter baumannii in patients who had undergone cardiac surgery. We describe the emergence of colistin-resistant K. pneumoniae harbouring bla CTX-M-15, bla SHV-11, bla OXA-1, bla TEM-1 beta-lactamases and aac(6’)-Ib-cr fluoroquinolone resistance. Colistin-resistant K. pneumoniae infections (pneumonia, wound infection, urinary tract infections and bacteraemia) occurred in critically ill patients previously treated with colistin for post-surgery infections with carbapenem-resistant Pseudomonas aeruginosa and/or A. baumannii. Although the cause of death could not be directly attributed to a single pathogen, three patients co-infected/colonised with K. pneumoniae, P. aeruginosa and/or A. baumannii died, whilst a fourth patient who had a mono-microbial infection with colistin-resistant K. pneumoniae only survived. The use of mobile intubation equipment in patients that shared the same ward, the clustering of cases over a short period of time, as well as the pulsed-field gel electrophoresis (PFGE) data all suggest cross-contamination between patients, either through equipment or by staff contact transmission. This report presents the ‘worst-case scenario’ where concurrent infection/colonisation with pathogens exhibiting resistance to different types of last-resort antimicrobials occurred in some of the most debilitated intensive care unit (ICU) patients. |
| Databáze: | OpenAIRE |
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