Premium
The first major extended‐spectrum β‐lactamase outbreak in Scandinavia was caused by clonal spread of a multiresistant Klebsiella pneumoniae producing CTX‐M‐15
Author(s) -
LYTSY BIRGITTA,
SANDEGREN LINUS,
TANO EVA,
TORELL ERIK,
ANDERSSON DAN I.,
MELHUS ÅSA
Publication year - 2008
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/j.1600-0463.2008.00922.x
Subject(s) - klebsiella pneumoniae , microbiology and biotechnology , aztreonam , cefotaxime , ceftazidime , cefpodoxime , etest , trimethoprim , pulsed field gel electrophoresis , biology , piperacillin , virology , molecular epidemiology , ciprofloxacin , antibiotics , imipenem , genotype , antibiotic resistance , bacteria , escherichia coli , pseudomonas aeruginosa , genetics , gene , biochemistry
Between May and December 2005, 64 multidrug‐resistant isolates of Klebsiella pneumoniae were detected from patients admitted to Uppsala University Hospital. This represented a dramatic increase in ESBL‐producing K. pneumoniae compared to previous years. To investigate the epidemiology and to characterize the resistance mechanisms of the isolates, a study was initiated. Antibiotic susceptibility was determined by means of the Etest and the disc diffusion method. Extended‐spectrum beta‐lactamase (ESBL) production was identified by clavulanic acid synergy test and confirmed with PCR amplification followed by DNA sequencing. DNA profiles of the isolates were examined with pulsed‐field gel electrophoresis (PFGE). All isolates were resistant or exhibited reduced susceptibility to cefadroxil, cefuroxime, cefotaxime, ceftazidime, aztreonam, piperacillin/tazobactam, ciprofloxacin, tobramycin, and trimethoprim‐sulfamethoxazole. They produced ESBL of the CTX‐M‐15 type, and the involvement of a single K. pneumoniae clone was shown. This is the first major clonal outbreak of multiresistant ESBL‐producing K. pneumoniae in Scandinavia. The outbreak demonstrates the epidemic potential of enterobacteria containing ESBLs of the CTX‐M type, even in a country with a relatively low selective pressure and a low prevalence of multiresistant bacteria.