Outbreak of Klebsiella pneumoniae Carbapenemase-Producing Citrobacter freundii at a Tertiary Acute Care Facility in Miami, Florida. Infect Control Hosp Epidemiol 2017 Mar;38(3):320-326
Date
12/08/2016Pubmed ID
27923418DOI
10.1017/ice.2016.273Scopus ID
2-s2.0-85013676972 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
OBJECTIVE To describe the investigation and control of a rare cluster of Klebsiella pneumoniae carbapenemase-producing Citrobacter freundii in a hospital in southern Florida. METHODS An epidemiologic investigation, review of infection prevention procedures, and molecular studies including whole genome sequencing were conducted. RESULTS An outbreak of K. pneumoniae carbapenemase-3-producing C. freundii was identified at a tertiary hospital in Florida in 2014. Of the 6 cases identified, 3 occurred in the same intensive care unit and were caused by the same clone. For 2 of the 3 remaining cases, the isolates had low carbapenem minimum inhibitory concentrations and were unrelated by whole genome sequencing. As a response to the outbreak, supplementary environmental cleaning was implemented, including closure and terminal cleaning of the unit where the 3 cases clustered, in addition to the infection control bundle already in place at the time. No further cases were identified after these additional interventions. CONCLUSIONS Although C. freundii is not a species that commonly demonstrates carbapenem resistance, our findings suggest that carbapenemase-producing C. freundii may be underdetected even when active surveillance is in place and has a potential to cause hospital outbreak. Infect Control Hosp Epidemiol 2017;38:320-326.
Author List
Jiménez A, Castro JG, Munoz-Price LS, de Pascale D, Shimose L, Mustapha MM, Spychala CN, Mettus RT, Cooper VS, Doi YMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Anti-Bacterial Agents
Bacterial Proteins
Citrobacter freundii
Cross Infection
Disease Outbreaks
Enterobacteriaceae Infections
Female
Florida
Humans
Infection Control
Intensive Care Units
Klebsiella pneumoniae
Male
Microbial Sensitivity Tests
Middle Aged
Tertiary Care Centers
Young Adult
beta-Lactamases
