Molecular Epidemiology of a Citywide Outbreak of Extended‐Spectrum β‐Lactamase–ProducingKlebsiella pneumoniaeInfection | Zendy

John Quale | Zendy; David Landman | Zendy; Patricia A. Bradford | Zendy; M Visalli | Zendy; Jayshree Ravishankar | Zendy; Carlos Flores | Zendy; David Mayorga | Zendy; Kalyani Vangala | Zendy; Adedeyo Adedeji | Zendy

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Molecular Epidemiology of a Citywide Outbreak of Extended‐Spectrum β‐Lactamase–ProducingKlebsiella pneumoniaeInfection

Author(s) -

John Quale,

David Landman,

Patricia A. Bradford,

M Visalli,

Jayshree Ravishankar,

Carlos Flores,

David Mayorga,

Kalyani Vangala,

Adedeyo Adedeji

Publication year - 2002

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1086/342577

Subject(s) - klebsiella pneumoniae , cefepime , cefoxitin , medicine , amikacin , microbiology and biotechnology , outbreak , ciprofloxacin , molecular epidemiology , piperacillin , ceftazidime , epidemiology , pneumonia , ceftriaxone , cephalosporin , antibiotics , multiple drug resistance , imipenem , virology , biology , antibiotic resistance , genotype , pseudomonas aeruginosa , bacteria , staphylococcus aureus , escherichia coli , biochemistry , genetics , gene

Multidrug-resistant strains of Klebsiella pneumoniae are a problem in many hospitals. In 1999, the molecular epidemiology of K. pneumoniae with extended-spectrum beta-lactamases (ESBLs) was studied at 15 hospitals in Brooklyn. Of 824 unique patient isolates, 34% were presumptive ESBL producers. Of this subset, 34% were susceptible to cefoxitin, 42% to ciprofloxacin, 48% to ceftriaxone, 55% to piperacillin-tazobactam, 57% to amikacin, and 86% to cefepime. Ribotype analysis revealed 87 unique types. However, 2 clusters accounted for 35% of isolates and were present in most of the hospitals. One cluster was significantly more resistant to most antibiotics. Although there was a predominance of SHV-5, considerable heterogeneity of beta-lactamases was evident, even among isolates of the same cluster. A correlation was found between the use of cephalosporins and the prevalence of ESBL-producing strains of K. pneumoniae at each hospital. Our data suggest that there is an advanced outbreak of multidrug-resistant K. pneumonia infection that is affecting all Brooklyn hospitals.

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