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First outbreak of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae in Germany

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Abstract

We report the first outbreak of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae in Germany. The presence of KPC was confirmed by polymerase chain reaction (PCR). The KPC-encoding plasmid was analysed by transconjugation experiments, DNA sequencing, Southern blotting and isoelectric focussing. Typing was performed by pulsed-field gel electrophoresis (PFGE). An ertapenem-resistant K. pneumoniae with low minimum inhibitory concentrations (MIC) to other cabapenems (tested by the Vitek system) was isolated from the index patient in January 2008. A KPC-2 was identified after K. pneumoniae with identical susceptibility patterns had been isolated from two more patients. Despite the introduction of infection control measures, transmission occurred in five additional patients and three of the patients died from infections. The source of the outbreak strain remained unclear; however, the Tn4401-containing bla KPC-2 gene was similar to previously described isolates from Greece. Five months after the end of the outbreak, a KPC-K. pneumoniae was isolated from a patient who had been treated in Greece previously. Retrospectively, this patient was treated in November 2007 on the same unit as the index case. Typing revealed that all patients were colonised by the same strain. KPC-K. pneumoniae has been introduced to Germany possibly from Greece and transmission to other institutions is likely.

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Potential conflicts of interest

C.W. is a speaker for Pfizer and BD Diagnostics; M.A.W. is a speaker for Wyeth, Pfizer, MSD, Essex, Gilead, Astra Zeneca and Astellas. All other authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Hygiene-Institute, University of Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany

    C. Wendt, S. Schütt, A. H. Dalpke & S. Zimmermann

  2. Clinic for Anaesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    M. Konrad & M. A. Weigand

  3. Clinic for General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    M. Mieth & B. Trierweiler-Hauke

  4. Department of Environmental Health Science, Freiburg University Medical Centre, Breisacher Strasse 115 b, 79106, Freiburg, Germany

    K. Biehler & D. Jonas

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  1. C. Wendt
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Correspondence to C. Wendt.

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Wendt, C., Schütt, S., Dalpke, A.H. et al. First outbreak of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae in Germany. Eur J Clin Microbiol Infect Dis 29, 563–570 (2010). https://doi.org/10.1007/s10096-010-0896-0

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