Abstract
Introduction: Global spread of carbapenem-resistant Enterobacteriacea is a critical healthcare challenge due to limited therapeutic options. We report a nosocomial outbreak of OXA-48-producing Klebsiella pneumoniae in respiratory intensive care unit.
Aims and Objectives: To investigate the outbreak of carbapenem-resistant K. pneumoniae using molecular methods and clinical data.
Methods: All K. pneumoniae isolates were identified by MALDI-TOF mass spectrometry. Antimicrobial susceptibility was performed according to the European Committee on Antimicrobial Susceptibility Testing guidelines. Presence of the blaOXA-48 gene was detected by polymerase chain reaction. Molecular typing was performed with pulsed-field gel electrophoresis.
Results: During November and December 2016, eight patients with OXA-48-producing K. pneumoniae isolates in BAL were identified. In all strains MIC for imipenem, meropenem and colistin was 4 µg/mL, 8 µg/mL, and 0,25 µg/mL, respectively. Epidemiological data revealed that the first positive patient was transfered from foreign country. Typing of isolates showed that they were highly related. In all patients the same bronchoscope was used. The bronchoscope solutions taken for microbiological analysis remain negative. The usage of the suspected bronchoscope was discontinued and the outbreak was suspended.
Conclusion: There are many potential modes of nosocomial infections transmission in ICU. Bronchoscopy should always be taken in to the consideration if oubreaks occur even without microbiological confirmation. Our report emphasizes the importance of careful bronchoscope reprocessing and introducing of single-use bronchoscopes as a possible solution.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA4691.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018