Primer brote de Klebsiella pneumoniae productora de Carbapenemasa tipo KPC en un hospital de tercer nivel.

Abstract

Background: Enterobacterial infections resistant to carbapenems due to the production of carbapenemase type KPC have emerged as a major challenge in health centers. Currently, Klebsiella pneumoniae producer of carbapenemases (KpnKPC) is the most frequently isolated species of Enterobacteriaceae resistant to carbapenems. Its importance lies in the capacity acquired by the microorganism to inactivate all β-lactam antibiotics, limiting the therapeutic options. In 2011, the first outbreak of KpnKPC was identified in the Armed Forces Central Hospital of Uruguay, challenging prevention and control measures applied up to now. Objective: The objective of the study is to characterize the outbreak of KpnKPC in this health center that occurred in the period 2011 to 2015. and release lessons learned related to the implementation and effectiveness of control measures. Materials and methods: Descriptive observational study, using as sources the clinical, epidemiological and laboratory information collected during the outbreak and subsequent analysis. Results: Between 2011 and 2015 a total of 28 patients were colonized or infected with KpnKPC in the HCFFAA. The pulsed-field gel electrophoresis (PGFE) analysis showed the presence of a single clone. All patients, except the index case, had a previous contact with a patient with infection and / orcolonization. Conclusions: It is described the first outbreak by KpnKPC in a tertiary health care public institution, whose control represented an important institutional challenge with the implementation of an integrated control program, which influenced the dynamics of the care process and had an important economic impact.