Investigation of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae outbreaks in Hungary between 2005 and 2008

Acta Microbiol Immunol Hung. 2010 Mar;57(1):43-53. doi: 10.1556/AMicr.57.2010.1.4.

Abstract

Fourteen outbreaks in Hungary between 2005 and 2008 caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KP) were epidemiologically investigated and the isolated pathogens were characterized by molecular techniques. Ten of the fourteen outbreaks occurred in adult wards and four in neonatal units affecting a total number of 73 patients. The 54% [40] of the patients developed bloodstream infections and 21.9%-21.9% [16] pneumonia and surgical site infections, respectively. The overall rate of mortality proved high: 36.9% [27]. Outbreaks in adults affected more patients, had higher attack rates, were more prolonged in duration and had a 6.9-fold higher mortality rate than outbreaks observed in neonates. The outbreaks in neonates were caused by SHV-type ESBL-producing klebsiellae, while in the "adult outbreaks" exclusively CTX-M-type ESBL-KP strains were involved. While the outbreak strains isolated from neonatal units could be assigned to a variety of pulsotypes, the previously described K. pneumoniae epidemic clones, ST15 and ST147, could be identified among the pathogens causing outbreaks in adult units.

MeSH terms

  • Adult
  • Alleles
  • DNA, Bacterial / genetics
  • Humans
  • Hungary / epidemiology
  • Incidence
  • Infant, Newborn
  • Intensive Care, Neonatal
  • Klebsiella Infections / epidemiology*
  • Klebsiella Infections / mortality
  • Klebsiella pneumoniae / enzymology*
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification
  • Molecular Epidemiology
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism*

Substances

  • DNA, Bacterial
  • GES-1 beta-lactamase
  • beta-Lactamases