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Diversity of clonal types of Klebsiella pneumoniae causing infections in intensive care neonatal patients in a large urban setting

  • Clinical Microbiology - Research Paper
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Abstract

Background

Klebsiella infections are reported from neonatal intensive care units (NICUs) worldwide, but data on their incidence and genetic diversity remain scarce.

Objective

We determined the incidence and genetic diversity of Klebsiella infections in NICU patients in Rio de Janeiro.

Methods

This was a prospective study including newborns admitted to NICU in three hospitals during April 2005–November 2006 and March 2008–February 2009. Klebsiella pneumoniae isolates were genotyped by multilocus sequence typing (MLST) and extended spectrum β-lactamases (ESBL) were characterized.

Results

Klebsiella infections occurred in 38 of 3984 patients (incidence rate, 9.5/1000 admissions); 14 (37%) of these 38 newborns died. Two clonal groups, CC45 and CC1041, caused 11 cases (42% of K. pneumoniae infection). Ten (32%) of the isolates causing infection produced ESBL, 9 of which (83%) carried blaCTX-M-15, all belonging to clonal complex (CC) 45 and CC1041. Nine of these ESBL-producing isolates were confined to only one of the NICUs.

Major conclusions

The high incidence of Klebsiella infections in NICU in Rio de Janeiro appeared to be due to a combination of frequent sporadic infections caused by multiple K. pneumoniae genotypes and small outbreaks caused by dominant multidrug-resistant clones.

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Acknowledgments

We thank platform Genotyping of Pathogens and Public Health (Institut Pasteur, Paris, France) for curating MLST allele sequences and profiles and making them available at http://bigsdb.pasteur.fr.

Financial support

This study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Finance Code 001, Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) of Brazil and Fogarty International Program in Global Infectious Diseases (TW006563) of the National Institute of Health.

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Authors and Affiliations

  1. Instituto de Microbiologia, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Lab I2-59, 21941-902, Cidade Universitária, Rio de Janeiro, RJ, Brazil

    Livia Helena Justo-da-Silva, Lara Feital Montezzi, Valéria Brígido Carvalho Girão, Renata Cristina Picão & Beatriz Meurer Moreira

  2. Faculdade de Medicina, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Lab I2-59, 21941-902, Cidade Universitária, Rio de Janeiro, RJ, Brazil

    Andrea Nunes De-Azeredo, Antônio José Ledo Alves da Cunha, Carmem Lucia Pessoa-Silva, Cristina Barroso Hofer & Guilherme Santoro-Lopes

  3. Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil

    Arnaldo Costa Bueno, Maria Beatriz Gerardin Poirot Leobons, Patrícia de Souza Inhaquite & Rosana Rangel Santos

  4. Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil

    Maria Silvana Alves

  5. University of California, Berkeley, CA, USA

    Lee Woodland Riley

Authors
  1. Livia Helena Justo-da-Silva
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  2. Andrea Nunes De-Azeredo
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  16. Beatriz Meurer Moreira
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Corresponding author

Correspondence to Beatriz Meurer Moreira.

Ethics declarations

The study was approved by the ethics committees of the Brazilian institutions Hospital Universitário Clementino Fraga Filho (Protocol No. 235/04) and of Secretaria Municipal de Saúde of Rio de Janeiro (Protocol No. 75/08).

Conflict of interest

The authors declare that they have no conflict of interest.

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Responsible Editor: Afonso Barth

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Livia Helena Justo-da-Silva wrote this manuscript.

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Justo-da-Silva, L.H., De-Azeredo, A.N., Bueno, A.C. et al. Diversity of clonal types of Klebsiella pneumoniae causing infections in intensive care neonatal patients in a large urban setting. Braz J Microbiol 50, 935–942 (2019). https://doi.org/10.1007/s42770-019-00128-9

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  • DOI: https://doi.org/10.1007/s42770-019-00128-9

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