Gert van der Hoek
In Memoriam - Editor, Senior Moderator
jan 4, 2012
Nosocomial outbreak of carbapenem-resistant Enterobacter cloacae highlighting the interspecies transferability of the blaOXA-48 gene in the gut flora
Lise Crémet1,2, Céline Bourigault1, Didier Lepelletier1,2, Aurélie Guillouzouic1,2, Marie-Emmanuelle Juvin1, Alain Reynaud1,2, Stéphane Corvec1,2 and Nathalie Caroff2,*
+ Author Affiliations
1Service de Bactériologie-Hygiène, CHU de Nantes, 9 quai Moncousu, 44093 Nantes cedex 1, France
2Université de Nantes, EA3826 Thérapeutiques cliniques et expérimentales des infections, UFR de Médecine, 1 rue G. Veil, 44000 Nantes, France
↵*Corresponding author. Tel: +33-2-53-48-41-66; Fax: +33-2-40-08-38-29; E-mail: nathalie.caroff@univ-nantes.fr
Sir,
The emergence and dissemination of carbapenemases (KPC, VIM, IMP, NDM or OXA-48) among Enterobacteriaceae is a serious concern worldwide as it raises the problem of the lack of therapeutic options linked to frequent co-resistance.1
In November 2010, French guidelines were published to control the spread of carbapenemase-producing Enterobacteriaceae from patients repatriated and travellers hospitalized in French hospitals.1
However, we report the in vivo interspecies transferability of the OXA-48 carbapenemase by the investigation and management of a nosocomial outbreak in France.
In April 2011, an elderly patient (Patient A) was transferred from Agadir (Morocco) to the internal medicine unit at Nantes University Hospital, France, for the treatment of a hip prosthetic joint infection. Upon admission, contact precautions were immediately adopted.
A rectal swab inoculated on CHROMagar™ KPC medium (CHROMagar, Paris, France) revealed the gastrointestinal carriage of Enterobacter cloacae and Escherichia coli, both resistant to ertapenem and positive for blaOXA-48 by PCR.2
Therefore, a weekly colonization surveillance was performed on all patients hospitalized in the unit, and led to the discovery of OXA-48-producing E. cloacae in 3/54 patients (B, C and D) without recent history of travel.
Furthermore, rectal swabs performed for Patients A and B found two OXA-48-producing Klebsiella pneumoniae isolates (Figure 1). The time between …
Read more behind a paywall ....
thanks to Dave Roberts
Nosocomial outbreak of carbapenem-resistant Enterobacter cloacae highlighting the interspecies transferability of the blaOXA-48 gene in the gut flora
Lise Crémet1,2, Céline Bourigault1, Didier Lepelletier1,2, Aurélie Guillouzouic1,2, Marie-Emmanuelle Juvin1, Alain Reynaud1,2, Stéphane Corvec1,2 and Nathalie Caroff2,*
+ Author Affiliations
1Service de Bactériologie-Hygiène, CHU de Nantes, 9 quai Moncousu, 44093 Nantes cedex 1, France
2Université de Nantes, EA3826 Thérapeutiques cliniques et expérimentales des infections, UFR de Médecine, 1 rue G. Veil, 44000 Nantes, France
↵*Corresponding author. Tel: +33-2-53-48-41-66; Fax: +33-2-40-08-38-29; E-mail: nathalie.caroff@univ-nantes.fr
Sir,
The emergence and dissemination of carbapenemases (KPC, VIM, IMP, NDM or OXA-48) among Enterobacteriaceae is a serious concern worldwide as it raises the problem of the lack of therapeutic options linked to frequent co-resistance.1
In November 2010, French guidelines were published to control the spread of carbapenemase-producing Enterobacteriaceae from patients repatriated and travellers hospitalized in French hospitals.1
However, we report the in vivo interspecies transferability of the OXA-48 carbapenemase by the investigation and management of a nosocomial outbreak in France.
In April 2011, an elderly patient (Patient A) was transferred from Agadir (Morocco) to the internal medicine unit at Nantes University Hospital, France, for the treatment of a hip prosthetic joint infection. Upon admission, contact precautions were immediately adopted.
A rectal swab inoculated on CHROMagar™ KPC medium (CHROMagar, Paris, France) revealed the gastrointestinal carriage of Enterobacter cloacae and Escherichia coli, both resistant to ertapenem and positive for blaOXA-48 by PCR.2
Therefore, a weekly colonization surveillance was performed on all patients hospitalized in the unit, and led to the discovery of OXA-48-producing E. cloacae in 3/54 patients (B, C and D) without recent history of travel.
Furthermore, rectal swabs performed for Patients A and B found two OXA-48-producing Klebsiella pneumoniae isolates (Figure 1). The time between …
Read more behind a paywall ....
thanks to Dave Roberts