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Long-lasting outbreak due to CTX-M-15-producing Klebsiella pneumoniae ST336 in a rehabilitation ward: report and literature review.

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Authors
Valsdottir, F
Elfarsdottir Jelle, A
Gudlaugsson, O
Hilmarsdottir, I
Issue Date
2017-09

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Long-lasting outbreak due to CTX-M-15-producing Klebsiella pneumoniae ST336 in a rehabilitation ward: report and literature review. 2017, 97 (1):42-51 J. Hosp. Infect.
Abstract
Whereas Klebsiella species are the most frequently occurring agents in nosocomial outbreaks due to multidrug-resistant Gram-negative organisms, very few outbreaks have been reported from rehabilitation wards.
To describe a long-lasting outbreak due to extended-spectrum β-lactamase-producing (ESBL) Klebsiella pneumoniae in a rehabilitation ward.
ESBL K. pneumoniae from all in- and outpatients whose specimens were tested at a tertiary care university hospital between 2007 and 2012 were typed by pulsed-field gel electrophoresis and selected isolates were submitted to multi-locus sequence typing and ESBL genotyping. Outbreak characteristics and infection control interventions were summarized. The literature was searched for K. pneumoniae-related outbreaks in rehabilitation wards.
ESBL K. pneumoniae was detected in 69 out of 2478 K. pneumoniae-positive patients (2.8%) during the study period. Eight related outbreak clones from 35 patients, 25 of whom were in the rehabilitation ward, produced CTX-M-15 and belonged to ST336. The outbreak lasted for more than three years and was controlled by sequentially increasing measures culminating in review of all patient-related care, compulsory educational meetings for personnel, profession-specific guidelines and educational flyers for patients.
Half of ESBL K. pneumoniae-positive patients identified over six years at a tertiary care university hospital harboured related clones, and more than a third were hospitalized in a rehabilitation ward. Rehabilitation wards pose particular challenges for infection control because of patient dependency and an environment that encourages socializing. They are, however, rarely involved in K. pneumoniae-related outbreaks.
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https://ac.els-cdn.com/S0195670117301883/1-s2.0-S0195670117301883-main.pdf?_tid=8e293456-a205-11e7-93e6-00000aab0f01&acdnat=1506353228_781a92f2d01dd293efe16c97dd83fcc4
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Archived with thanks to The Journal of hospital infection
ae974a485f413a2113503eed53cd6c53
10.1016/j.jhin.2017.04.002
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