Medical College of Wisconsin
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Outbreak of Klebsiella pneumoniae Carbapenemase-Producing Citrobacter freundii at a Tertiary Acute Care Facility in Miami, Florida. Infect Control Hosp Epidemiol 2017 03;38(3):320-326



Pubmed ID





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 Y


L Silvia Munoz-Price MD, PhD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anti-Bacterial Agents
Bacterial Proteins
Citrobacter freundii
Cross Infection
Disease Outbreaks
Enterobacteriaceae Infections
Infection Control
Intensive Care Units
Klebsiella pneumoniae
Microbial Sensitivity Tests
Middle Aged
Tertiary Care Centers
Young Adult
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0