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Raman spectroscopic analysis of the clonal and horizontal spread of CTX-M-15-producing Klebsiella pneumoniae in a neonatal intensive care unit

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Abstract

Nosocomial outbreaks of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae are an increasing concern in neonatal intensive care units (NICUs). We describe an outbreak of ESBL-producing K. pneumoniae that lasted 5 months and affected 23 neonates in our NICU. Proton pump inhibitor and extended-spectrum cephalosporin exposure were significantly associated with the risk of ESBL-producing K. pneumoniae colonisation and/or infection. Thirty isolates recovered from clinical, screening and environmental samples in the NICU were studied by means of Raman spectroscopy, pulsed-field gel electrophoresis and repetitive extragenic palindromic polymerase chain reaction (rep-PCR). The Raman clustering was in good agreement with the results of the other two molecular methods. Fourteen isolates belonged to the Raman clone 1 and 16 to the Raman clone 3. Molecular analysis showed that all the strains expressed SHV-1 chromosomal resistance, plasmid-encoded TEM-1 and CTX-M-15 β-lactamases. Incompatibility groups of plasmid content identified by PCR-based replicon typing indicated that resistance dissemination was due to the clonal spread of K. pneumoniae and horizontal CTX-M-15 gene transfer between the two clones.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. APHP, Laboratoire de Microbiologie, Hôpital Robert Debré, 48, Bld. Serurier, 75935, Paris, France

    K. Guyot, C. Doit, C. Courroux & E. Bingen

  2. Faculté de Médecine Paris Diderot, Sorbonne Paris Cité, EA 3105, 75505, Paris, France

    K. Guyot, C. Doit & E. Bingen

  3. APHP, Service de Réanimation et Pédiatrie Néonatales, Hôpital Robert Debré, 75935, Paris, France

    V. Biran & Y. Aujard

  4. INSERM, U676, Equipe AVENIR RO5230HS, Paris, France

    V. Biran & Y. Aujard

  5. APHP, Laboratoire de Microbiologie, Hôpital Armand-Trousseau, Paris, France

    D. Moissenet & H. VuThien

  6. Faculté de Médecine Saint-Antoine, Université Pierre et Marie Curie-Paris 6, Paris, France

    D. Moissenet & H. VuThien

  7. CHU Reims, Laboratoire de Bactériologie-Virologie-Hygiène, Hôpital Robert Debré, 51092, Reims, France

    T. Guillard, L. Brasme & C. De Champs

  8. Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands

    K. Maquelin & W. van Leeuwen

  9. Department of Dermatology, Erasmus Medical Center, Rotterdam, The Netherlands

    K. Maquelin

  10. River Diagnostics BV, Rotterdam, The Netherlands

    K. Maquelin

Authors
  1. K. Guyot
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  2. V. Biran
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  3. C. Doit
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  4. D. Moissenet
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  5. T. Guillard
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  6. L. Brasme
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  7. C. Courroux
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  8. K. Maquelin
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  9. W. van Leeuwen
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  10. H. VuThien
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  11. Y. Aujard
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  12. C. De Champs
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  13. E. Bingen
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Corresponding author

Correspondence to E. Bingen.

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Guyot, K., Biran, V., Doit, C. et al. Raman spectroscopic analysis of the clonal and horizontal spread of CTX-M-15-producing Klebsiella pneumoniae in a neonatal intensive care unit. Eur J Clin Microbiol Infect Dis 31, 2827–2834 (2012). https://doi.org/10.1007/s10096-012-1636-4

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  • DOI: https://doi.org/10.1007/s10096-012-1636-4

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