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Gram-negative bacteria that produce carbapenemases causing death attributed to recent foreign hospitalization

Jasmine Ahmed-Bentley1, A Uma Chandran, A Mark Joffe

  • 1University of Alberta, Calgary, Alberta, Canada.

Antimicrobial Agents and Chemotherapy
|April 25, 2013
PubMed

Insights

Overseas travel can introduce dangerous antimicrobial-resistant bacteria. A Canadian patient hospitalized in India brought carbapenemase-producing bacteria home, leading to an outbreak and one death.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Antimicrobial resistance (AMR) is a growing global health threat.
  • Carbapenemase-producing Gram-negative bacteria (CP-GNB) are particularly concerning due to limited treatment options.
  • Overseas travel is an identified risk factor for acquiring infections with multidrug-resistant organisms (MDROs).

Observation:

  • A Canadian patient returning from hospitalization in India presented with a wound colonized by multidrug-resistant Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii.
  • Surveillance cultures were initiated as part of outbreak management.
  • Epidemiological and molecular investigations were conducted to trace the spread of resistant strains.

Findings:

  • NDM-1-producing K. pneumoniae ST16 and OXA-23-producing A. baumannii ST10 strains were identified.
  • These strains were transmitted to five additional patients, resulting in colonization in four and fatal septic shock in one patient due to A. baumannii.
  • Screening cultures exhibited a high false-positive rate, increasing workload and costs.

Implications:

  • This is the first reported death in Canada linked to carbapenemase-producing Gram-negative bacteria acquired during foreign hospitalization.
  • Routine screening for MDRO colonization in patients with recent foreign hospitalizations is recommended.
  • Enhanced infection control measures are crucial for preventing the importation and spread of resistant pathogens.

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