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Outbreak of OXY-2-Producing Klebsiella oxytoca in a renal transplant unit

Mariela Soledad Zárate1, Ana C Gales, Renata C Picão

  • 1Laboratorio de Bacteriología, Micología y Parasitología, Sección de Nefrología, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno CEMIC, Ciudad Autónoma de Buenos Aires, Argentina. sole_z@hotmail.com

Journal of Clinical Microbiology
|April 18, 2008
PubMed

Insights

A Klebsiella oxytoca outbreak occurred in a renal transplant unit, affecting seven patients. The infection was linked to a specific gene mutation causing antibiotic resistance.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Klebsiella oxytoca is an opportunistic pathogen.
  • Renal transplant recipients are susceptible to infections.
  • Antibiotic resistance is a growing global health concern.

Purpose of the Study:

  • To investigate an outbreak of Klebsiella oxytoca infection.
  • To characterize the antibiotic resistance profile of the outbreak strains.
  • To identify the genetic basis of resistance.

Main Methods:

  • Pulsed-field gel electrophoresis (PFGE) for strain typing.
  • Antimicrobial susceptibility testing.
  • Genetic analysis of beta-lactamase genes.

Main Results:

  • Seven patients in a renal transplant unit were infected.
  • All isolates showed a single PFGE pattern.
  • Resistance to amoxicillin-clavulanate, cefuroxime, piperacillin-tazobactam, and aztreonam.
  • Susceptibility to ceftriaxone, ceftazidime, cefepime, and imipenem.
  • A point mutation in the bla(OXY-2) gene promoter region caused beta-lactamase hyperproduction.

Conclusions:

  • A single clone of Klebsiella oxytoca caused the outbreak.
  • The outbreak was associated with a specific genetic mutation leading to antibiotic resistance.
  • Effective treatment options included ceftriaxone, ceftazidime, cefepime, and imipenem.

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