Nosocomial transmission of carbapenem-resistant Klebsiella pneumoniae in an Italian university hospital: a molecular epidemiological study

G. Sotgiu, B. M. Are, L. Pesapane, A. Palmieri, N. Muresu, A. Cossu, M. Dettori, A. Azara, I. I. Mura, C. Cocuzza, S. Aliberti, A. Piana

Research output: Contribution to journalArticle

Abstract

Aim: To describe the phenotypic and genotypic profiles of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains isolated from patients with invasive infections at an Italian university hospital in order to assess the epidemiological trend. Methods: An observational prospective study was undertaken at the University Hospital of Sassari, Italy to detect KPC-Kp strains in patients with invasive bacteraemia. Isolates were identified phenotypically; carbapenemase production was assessed using phenotypic and genotypic methods. Sequencing of blaKPC genes, pulsed-field gel electrophoresis and multi-locus sequence typing were performed. Results: During the period 2015–2017, 46 cases of invasive infection with K. pneumoniae were recorded. Two-thirds (67.4%) of the patients were male, and the mean age was 69.4 years. Most patients had at least one comorbidity (56.5%) and/or had been hospitalized previously (70.5%), 81.8% had current or recent medical device use, and 85.4% had recent antibiotic exposure. The mortality rate was 52.3%. A multi-drug-resistant pattern (including carbapenems, fluoroquinolones, third-/fourth-generation cephalosporins) was shown for all K. pneumoniae isolates. KPC-3 and -2 were produced by all strains. The most common sequence types were 512 (91.3%) and 101 (8.7%), grouped into three clusters (A, A1 and B). Conclusions: A high incidence of KPC-Kp in patients with invasive infections was recorded at an Italian university hospital compared with the incidence measured before 2015. This study confirmed the importance of the KPC-3 carbapenemase variant, as reported by other Italian studies. High mortality and comorbidity rates appear to be associated with KPC-Kp infection.

Original languageEnglish
Pages (from-to)413-418
Number of pages6
JournalJournal of Hospital Infection
Volume99
Issue number4
DOIs
Publication statusPublished - Aug 1 2018

Keywords

  • Genotypic analysis
  • Klebsiella pneumoniae carbapenemase-producing K. pneumoniae
  • Surveillance

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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