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Epidemiology and molecular characterization of nosocomially transmitted multidrug-resistant Klebsiella pneumoniae

N Parasakthi1, J Vadivelu, H Ariffin

  • 1Department of Medical Microbiology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. parasak@medicine.med.um.edu.my

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|February 17, 2001
PubMed
Abstract

Insights

This study investigated a multidrug-resistant Klebsiella pneumoniae outbreak in a pediatric oncology unit. The outbreak was controlled by reinforcing infection control and addressing environmental contamination, not clonal spread.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Epidemiology

Background:

  • Nosocomial outbreaks of multidrug-resistant Klebsiella pneumoniae (MRKP) pose significant threats in healthcare settings, particularly in immunocompromised populations.
  • Pediatric oncology units are vulnerable to healthcare-associated infections due to patients' weakened immune systems.

Purpose of the Study:

  • To investigate the epidemiology, antimicrobial susceptibility, genomic profiles, and control measures of a nosocomial MRKP outbreak.
  • To identify the source and transmission dynamics of MRKP within a pediatric oncology ward.

Main Methods:

  • Prospective epidemiologic and microbiologic study of MRKP isolates from patients and environmental samples.
  • Antimicrobial susceptibility testing, plasmid analysis, and pulsed-field gel electrophoresis (PFGE) for genomic profiling.

Main Results:

  • MRKP isolates were resistant to ceftazidime, sensitive to imipenem and ciprofloxacin, and were extended-spectrum beta-lactamase (ESBL) producers.
  • PFGE analysis revealed six distinct DNA profiles (A-F), indicating the outbreak strains were not clonal in origin.
  • Common large plasmids (80-100 kb) were found in eight isolates, suggesting potential for horizontal gene transfer.

Conclusions:

  • The MRKP outbreak strains were not clonally related, implying multiple introductions or diverse sources.
  • The successful control of the outbreak was attributed to the reemphasis of standard infection control procedures.
  • Implementing a program to address environmental contamination was crucial in curbing the spread of MRKP.

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