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. 2013 Aug;141(8):1705-12.
doi: 10.1017/S0950268812002099. Epub 2012 Oct 4.

The emergence of multidrug-resistant Klebsiella pneumoniae of international clones ST13, ST16, ST35, ST48 and ST101 in a teaching hospital in the Paris region

G Marcade  1 , S Brisse, S Bialek, E Marcon, V Leflon-Guibout, V Passet, R Moreau, M-H Nicolas-Chanoine
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The emergence of multidrug-resistant Klebsiella pneumoniae of international clones ST13, ST16, ST35, ST48 and ST101 in a teaching hospital in the Paris region

G Marcade et al. Epidemiol Infect. 2013 Aug.

Abstract

Despite infection control measures, an important increase in the extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae incidence density occurred in our hospital from 2006 onwards. This study, focusing on the 2005-2007 period, was performed in an attempt to explain this increase. ESBLs were characterized, isolates were typed by ERIC2-PCR, and sequence type (ST) of clustered isolates was determined. Temporal-spatial relationships of patients were analysed to assess possible cross-contamination. Of the 74 ESBL-producing isolates, 30 (40%) were detected at admission, 53 (71∙5%) produced CTX-M enzymes, 40 displayed unique ERIC2-PCR profiles and 34 were assigned into six clusters: ST16 (n=21), ST101, ST48, ST35, ST13, and ST436. Relationships were identified in 22 of the 34 patients harbouring clustered isolates. This study highlights the complex epidemiology of ESBL-producing K. pneumoniae in the mid-2000s with potential cross-contamination for only 30% of the 74 patients in our hospital, and the emergence of clones that are currently spreading worldwide.

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Figures

Fig. 1.
Fig. 1.
Examples of ERIC2-PCR profiles from ESBL-producing Klebsiella pneumoniae. Seven unique profiles (U1, U2, U3, U4, U6, U7), and two representative isolates of cluster 2 (C2) and cluster 5 (C5) are presented. Lanes 1, 6 and 12 contain molecular-weight marker.
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