Outbreak due to a Klebsiella pneumoniae strain harbouring KPC-2 and VIM-1 in a German university hospital, July 2010 to January 2011

Abstract

We describe the epidemiology and characteristics ofthe pathogen and patients (n=7) associated with anoutbreak of a carbapenem-resistant Klebsiella pneumoniae(CRKP) strain in a German university hospitalfrom July 2010 to January 2011. Species identificationand detection of carbapenem resistance were carriedout using standard microbiological procedures.Carbapenemases were detected by phenotypic methodsand specific polymerase chain reactions (PCRs).DNA fingerprinting profiles were performed withrepetitive sequence-based PCR. Medical records ofcolonised or infected patients were retrospectivelyreviewed. Antibiotic resistance profiles, PCR-specificamplification products and genotyping demonstratedthat the outbreak occurred because of the spread ofa single CRKP clone harbouring both KPC-2 and VIM-1. Five of the seven patients had invasive infectionswith the CRKP strain; the deaths of four of them weredirectly related to the infection. Early implementationof infection control interventions brought aboutefficient containment of further cross-transmission.Rapid dissemination of carbapenemase-producingEnterobacteriaceae is a serious concern in patient careand is a problem that has emerged in western Europe.