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

Emese Szilágyi, M. Füzi, Ivelina Damjanova, Karolina Böröcz, Katalin Szonyi, Á Tóth, K. Nagy

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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.

Original languageEnglish
Pages (from-to)43-53
Number of pages11
JournalActa microbiologica et immunologica Hungarica
Volume57
Issue number1
DOIs
Publication statusPublished - Mar 1 2010

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Keywords

  • ESBL outbreak
  • MLST
  • PFGE

ASJC Scopus subject areas

  • Immunology and Microbiology(all)

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