First documented outbreak of KPC-2-producing Klebsiella pneumoniae in Switzerland: infection control measures and clinical management
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We report the epidemiological and clinical features of the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) type 2 in Switzerland. The outbreak took place in the medical intensive care unit (MICU) of our tertiary care hospital and affected three severely ill patients. After the implementation of strict infection control measures, no further patients colonised with KPC-KP could be detected by the screening of exposed patients. Successful treatment of patients infected with KPC-KP consisted of a combination therapy of meropenem, colistin and tigecycline.
KeywordsCarbapenem-resistant Enterobacteriaceae (CRE) KPC Klebsiella pneumoniae Outbreak Switzerland Infection control
The authors would like to thank Lauren Clack for the language support.
Conflict of interest
There was no financial support and the authors have no potential conflicts of interest to declare.
No formal informed consent was obtained from the patients, as this evaluation was considered to be within the context of the overall quality control system instituted at the hospital.
- 4.Giani T, Pini B, Arena F, Conte V, Bracco S, Migliavacca R, et al. Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011. Euro Surveill. 2013;18. pii: 20489.Google Scholar
- 7.Schweizerisches Zentrum für Antibiotikaresistenzen, anresis.ch. http://www.anresis.ch/de/index.html. Accessed 24 July 2013.
- 9.Babouee B, Widmer AF, Dubuis O, Ciardo D, Droz S, Betsch BY, et al. Emergence of four cases of KPC-2 and KPC-3-carrying Klebsiella pneumoniae introduced to Switzerland, 2009–10. Euro Surveill. 2011;16. pii: 19817.Google Scholar
- 11.Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA. Manual of clinical microbiology. 9th ed. Washington, DC: ASM Press; 2007.Google Scholar
- 12.Isenberg HD. Clinical microbiology procedures handbook. 2nd ed. Washington, DC: ASM Press; 2004.Google Scholar
- 13.Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twenty-second informational supplement (M100-S22). CLSI, Wayne, PA; 2012.Google Scholar
- 14.Babouee B, Frei R, Schultheiss E, Widmer AF, Goldenberger D. Comparison of the DiversiLab repetitive element PCR system with spa typing and pulsed-field gel electrophoresis for clonal characterization of methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 2011;49:1549–55.PubMedCentralPubMedCrossRefGoogle Scholar
- 15.ECDC risk assessment on the spread of carbapenemase-producing enterobacteriaceae (CPE) through patient transfer between healthcare facilities, with special emphasis on cross-border transfer. http://www.ecdc.europa.eu/en/activities/diseaseprogrammes/ARHAI/Pages/risk_assessment_CPE.aspx. Accessed 3 July 2013.
- 16.WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care. Geneva: World Health Organization; 2009. http://www.ncbi.nlm.nih.gov/books/NBK144013/. Accessed 24 July 2013.