Rapid molecular technique analysis of a KPC-3-producing Klebsiella pneumoniae outbreak in an Italian surgery unit
A Mazzariol1, G Lo Cascio, P Ballarini
1Department of Pathology and Diagnostics, University of Verona, Italy.
Abstract:
The rapid emergence of KPC-producing Klebsiella pneumoniae has become a serious problem in health-care settings, increasing in frequency worldwide. These infections are worrisome, since the antimicrobial treatment options for infections due to multidrug-resistant strains are very limited, and outbreaks must be rapidly detected and controlled. A semi-automated, repetitive-sequence-based PCR (rep-PCR) instrument (DiversiLab system) was evaluated in comparison with the pulse-field gel electrophoresis (PFGE) and multilocus sequence typing to investigate the outbreak of KPC-producing K. pneumoniae in a surgery unit at the University Hospital of Verona, Italy, as a rapid method for outbreak investigations. A selection of seven epidemiologically related K. pneumoniae showing resistance to carbapenem and three epidemiologically unrelated K. pneumoniae isolates were collected from patient with hospital-acquired infection. Among the epidemiologically related isolates, PFGE and Rep-PCR identified a unique pattern with more than 90% of homology. The concordance between DiversiLab and PFGE results confirmed the usefulness of rapid molecular techniques to investigate outbreaks due to multidrug-resistant bacteria. Moreover, this result could meet the international need for a harmonised typing tool, allowing the implementation of strict control measures to prevent dissemination of these organisms in health-care settings.
Insights
Rapid molecular techniques like rep-PCR can quickly identify outbreaks of carbapenem-resistant Klebsiella pneumoniae (KPC). This aids in controlling the spread of these dangerous multidrug-resistant bacteria in healthcare settings.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Carbapenemase-producing Klebsiella pneumoniae (KPC) infections are a growing global threat in healthcare.
- Limited antimicrobial options and rapid spread necessitate effective outbreak detection and control.
Purpose of the Study:
- To evaluate a semi-automated repetitive-sequence-based PCR (rep-PCR) system for investigating KPC-producing K. pneumoniae outbreaks.
- To compare rep-PCR with established methods like pulse-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).
Main Methods:
- A DiversiLab rep-PCR system was used to analyze K. pneumoniae isolates.
- Results were compared with PFGE and MLST for epidemiologically related and unrelated isolates.
- Carbapenem resistance and hospital-acquired infections were key characteristics.
Main Results:
- Rep-PCR and PFGE identified a unique pattern with over 90% homology among related K. pneumoniae isolates.
- High concordance between DiversiLab rep-PCR and PFGE confirmed the utility of molecular typing.
- Unrelated isolates showed distinct patterns.
Conclusions:
- Rep-PCR is a rapid and effective tool for investigating outbreaks of multidrug-resistant bacteria like KPC-producing K. pneumoniae.
- This method supports international needs for harmonized typing tools for infection control.
- Implementing such techniques aids in preventing the dissemination of resistant organisms in healthcare facilities.
