Emerg Infect Dis. 2023 Aug;29(8):1531-1539. doi: 10.3201/eid2908.230484.
After an increase in carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections and associated deaths in the neonatal unit of a South Africa hospital, we conducted an outbreak investigation during October 2019-February 2020 and cross-sectional follow-up during March 2020-May 2021. We used genomic and epidemiologic data to reconstruct transmission networks of outbreak-related clones. We documented 31 cases of culture-confirmed CRKP infection and 14 deaths. Two outbreak-related clones (bla sequence type [ST] 152 [n = 16] and bla ST307 [n = 6]) cocirculated. The major clone bla ST152 accounted for 9/14 (64%) deaths. Transmission network analysis identified possible index cases of bla ST307 in October 2019 and bla ST152 in November 2019. During the follow-up period, 11 new cases of CRKP infection were diagnosed; we did not perform genomic analysis. Sustained infection prevention and control measures, adequate staffing, adhering to bed occupancy limits, and antimicrobial stewardship are key interventions to control such outbreaks.
在南非一家医院的新生儿病房中，碳青霉烯类耐药肺炎克雷伯菌（CRKP）血流感染和相关死亡人数增加后，我们在 2019 年 10 月至 2020 年 2 月期间进行了暴发调查，并在 2020 年 3 月至 2021 年 5 月期间进行了横断面随访。我们使用基因组和流行病学数据来重建暴发相关克隆的传播网络。我们记录了 31 例经培养证实的 CRKP 感染和 14 例死亡病例。两个暴发相关的克隆（bla 序列型 [ST] 152 [n = 16] 和 bla ST307 [n = 6]）同时传播。主要克隆 bla ST152 导致 14 例死亡中的 9 例（64%）。传播网络分析确定了 2019 年 10 月 bla ST307 和 2019 年 11 月 bla ST152 的可能的首例病例。在随访期间，又诊断出 11 例新的 CRKP 感染病例；我们未进行基因组分析。持续的感染预防和控制措施、充足的人员配备、遵守床位占用限制和抗菌药物管理是控制此类暴发的关键干预措施。
