Outbreak due to a Klebsiella pneumoniae strain harbouring KPC-2 and VIM-1 in a German university hospital, July 2010 to January 2011

J Steinmann; M Kaase; S Gatermann; W Popp; E Steinmann; M Damman; A Paul; F Saner; J Buer; P M Rath

doi:10.2807/ese.16.33.19944-en

Surveillance and outbreak reports Open Access

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Outbreak due to a Klebsiella pneumoniae strain harbouring KPC-2 and VIM-1 in a German university hospital, July 2010 to January 2011
J Steinmann¹ , M Kaase² , S Gatermann² , W Popp³ , E Steinmann⁴ , M Damman⁵ , A Paul⁵ , F Saner⁵ , J Buer¹ , P M Rath¹
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Affiliations: ¹ Institute of Medical Microbiology, University Hospital Essen, University of Duisburg- Essen, Essen, Germany ² National Reference Laboratory for Multidrug Resistant Gram negative Bacteria, Department of Medical Microbiology, Ruhr University Bochum, Bochum, Germany ³ Hospital Hygiene, University Hospital Essen, University of Duisburg-Essen, Essen, Germany ⁴ Twincore Center for Experimental and Clinical Infection Research, Hannover, Germany ⁵ Department of General, Visceral and Transplant Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

Correspondence:
J Steinmann
Joerg.Steinmann uk-essen.de
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Citation style for this article: Steinmann J, Kaase M, Gatermann S, Popp W, Steinmann E, Damman M, Paul A, Saner F, Buer J, Rath P M. Outbreak due to a Klebsiella pneumoniae strain harbouring KPC-2 and VIM-1 in a German university hospital, July 2010 to January 2011 . Euro Surveill. 2011;16(33):pii=19944. https://doi.org/10.2807/ese.16.33.19944-en Received: 12 Apr 2011

Abstract

We describe the epidemiology and characteristics of the pathogen and patients (n=7) associated with an outbreak of a carbapenem-resistant Klebsiella pneumoniae (CRKP) strain in a German university hospital from July 2010 to January 2011. Species identification and detection of carbapenem resistance were carried out using standard microbiological procedures. Carbapenemases were detected by phenotypic methods and specific polymerase chain reactions (PCRs). DNA fingerprinting profiles were performed with repetitive sequence-based PCR. Medical records of colonised or infected patients were retrospectively reviewed. Antibiotic resistance profiles, PCR-specific amplification products and genotyping demonstrated that the outbreak occurred because of the spread of a single CRKP clone harbouring both KPC-2 and VIM-1. Five of the seven patients had invasive infections with the CRKP strain; the deaths of four of them were directly related to the infection. Early implementation of infection control interventions brought about efficient containment of further cross-transmission. Rapid dissemination of carbapenemase-producing Enterobacteriaceae is a serious concern in patient care and is a problem that has emerged in western Europe.