Journal Article

Molecular Epidemiology of a Citywide Outbreak of Extended-Spectrum β-Lactamase–Producing <i>Klebsiella pneumoniae</i> Infection

John M. Quale, David Landman, Patricia A. Bradford, Melissa Visalli, Jayshree Ravishankar, Carlos Flores, David Mayorga, Kalyani Vangala and Adedeyo Adedeji

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 7, pages 834-841
Published in print October 2002 | ISSN: 1058-4838
Published online October 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/342577
Molecular Epidemiology of a Citywide Outbreak of Extended-Spectrum β-Lactamase–Producing Klebsiella pneumoniae Infection

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Multidrug-resistant strains of Klebsiella pneumoniae are a problem in many hospitals. In 1999, the molecular epidemiology of K. pneumoniae with extended-spectrum β-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 β-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.

Journal Article.  3542 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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