1Department of Clinical Microbiology, University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
2Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Acta Microbiol Immunol Hung. 2024 Aug 29;71(3):206-210. doi: 10.1556/030.2024.02364. Print 2024 Sep 18.
We report a nosocomial outbreak caused by a multidrug-resistant carbapenemase-producing Klebsiella pneumoniae (MDRCPKp), that was detected in six patients admitted to the medical intensive care unit between 20th of December 2023 and 15th of January 2024 in Ankara, Turkey. The investigation of this outbreak was started on 29th of December 2023. During the outbreak 11 samples were collected from the six patients with MDRCPKp. Pulsed-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness and clonality of MDRCPKp strains. MDRCPKp was isolated in the tracheal aspiration culture, blood, urine, and screening samples. Five patients with MDRCPKp colonization developed healthcare-associated infection. In one patient MDRCPKp was isolated from tracheal aspirate and the screening cultures were considered as colonization not infection. PFGE analysis revealed that all isolates belonged to the same K. pneumoniae clone. MDRCPKp strain of this outbreak exhibited multidrug resistance and co-produced OXA-48 and NDM-1. This outbreak ended after application of strict infection control measures. An outbreak of MDRCPKp can occur in hospitals, especially in the intensive care units; thus, it should be detected early by infection control teams. A strong collaboration between infection control team and microbiology laboratory is essential to cope with MDR bacterial outbreaks in hospitals.
我们报告了一起由产碳青霉烯酶的多重耐药肺炎克雷伯菌（MDRCPKp）引起的医院感染暴发，该起暴发发生于 2023 年 12 月 20 日至 2024 年 1 月 15 日期间，土耳其安卡拉的一家医疗重症监护病房的 6 名患者中。该起暴发的调查于 2023 年 12 月 29 日开始。在暴发期间，从 6 名携带 MDRCPKp 的患者中采集了 11 份样本。进行脉冲场凝胶电泳（PFGE）以确定 MDRCPKp 菌株的遗传相关性和克隆性。在气管抽吸培养物、血液、尿液和筛查样本中分离出 MDRCPKp。5 名携带 MDRCPKp 定植的患者发生了与医疗保健相关的感染。在 1 名患者中，从气管抽吸物中分离出 MDRCPKp，且筛查培养物被认为是定植而非感染。PFGE 分析显示所有分离株均属于同一肺炎克雷伯菌克隆。该起暴发的 MDRCPKp 株表现出多药耐药性，同时产生 OXA-48 和 NDM-1。在实施严格的感染控制措施后，该起暴发结束。MDRCPKp 暴发可发生在医院，尤其是重症监护病房；因此，感染控制团队应尽早发现。感染控制团队和微生物实验室之间的密切合作对于应对医院中 MDR 细菌暴发至关重要。
