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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

Date

12/08/2016

Pubmed ID

27923418

DOI

10.1017/ice.2016.273

Abstract

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

Author

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

Adolescent
Adult
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
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0