Passive Layer Development and Corrosion of Steel in Concrete at the Nano-scale

Abstract

The considerable increase in carbapenem-resistant Klebsiella pneumoniae has caused an increase in mortality and morbidity rates. The aim of this study was to describe its epidemiological and microbiological characteristics and the intervention measures that controlled an outbreak caused by K. pneumoniae-producing KPC-2 B-lactamase. Methods The study was divided into 2 periods: the first during the outbreak with the implementation of a bundle and the second a post-outbreak surveillance. We performed tests for identification and susceptibility by using an automated system, screening carbapenemases by the Modified-Hodge test, blaKPC, blaKPC-2and NDM-1 identification by PCR and clonal relationship characterisation by PFGE. Results During the outbreak, there were 18 isolates of Klebsiella pneumoniae-producing KPC-2 in 11 patients. Three cases were confirmed as hospital-acquired infection. Of 22 isolates, 21 were positive to blaKPCby PCR (samples from patients and environment) and a clone was identified with a similarity of greater than 75%. During the post-outbreak surveillance, we did not find any new positive cultures from surfaces and there were no new colonisations. Discussion This was a successful control of an outbreak produced by a clone. The implementation of a bundle and a subsequent surveillance to monitor its fulfilment, effective communication and teamwork were crucial to inhibit propagation of the infection and to prevent an endemic behaviour post-outbreak.