Klebsiella pneumoniae blaNDM-1 carrying a class 1 integron causing a hospital outbreak in a Mexican attention center

• Published in: Journal of infection in developing countries 2021-05, Vol.15 (5), p.657-664
• Main Authors: Cortés-Ortíz, Iliana Alejandra, Juárez-Gómez, Julio Cesar, Cu-Quijano, Concepción, Flores-Paz, Rocio, Durán-Manuel, Emilio Mariano, Cruz-Cruz, Clemente, Gutiérrez-Muñoz, Victor Hugo, Sosa-Hernández, Oscar, Escobar-Escamilla, Noé, Bravata-Alcántara, Juan Carlos, Delgado-Balbuena, Laura, Ibáñez-Cervantes, Gabriela, Bello-López, Juan Manuel
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; beta-Lactamases - metabolism; Cloning; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - microbiology; Disease Outbreaks; Drug Resistance, Multiple, Bacterial; Female; Hospitals; Humans; Integrons; Klebsiella Infections - drug therapy; Klebsiella Infections - epidemiology; Klebsiella Infections - microbiology; Klebsiella pneumoniae - drug effects; Klebsiella pneumoniae - genetics; Klebsiella pneumoniae - isolation & purification; Klebsiella pneumoniae - metabolism; Male; Mexico - epidemiology; Microbial Sensitivity Tests; Middle Aged
• ISSN: 1972-2680; 2036-6590; 1972-2680
• DOI: 10.3855/jidc.12996

Infections acquired in hospitals are the cause of high morbidity and mortality and with the emergence of resistant bacteria, the problem is greater. The aim of this work was to determine the genetic characteristics and timeline of Klebsiella pneumoniae blaNDM-1 carrying a class 1 integron involved in an intrahospital outbreak. Investigation was made from the first detection of K. pneumoniae blaNDM-1, strain "466", and the last clone "423". 16S rRNA gene analysis showed that 466 strain and clones were related to K. pneumoniae. Extended-spectrum β-lactamases (ESBL) was detected according to the Clinical and Laboratory Standards Institute (CLSI) and real time-PCR. Typing of K. pneumoniae blaNDM-1 strains was carried by ERIC-PCR and sequencing the variable region of the integrons were performed. A cluster of six resistant isolates of K. pneumoniae blaNDM-1 was detected in intensive care unit (ICU), internal medicine (IM) and orthopedics (OT). Timeline revealed that the first bacterial identification was in ICU and the last clone in OT service. The array genetic of variable region was "IntI/aadA5-drfA17/qacEΔ1-Sul1". The evidences highlight the importance of the epidemiological surveillance of Extended-spectrum β-lactamases (ESBL) strains, as well as the need for molecular epidemiological studies to identify the routes of transmission and the contamination sources within health personnel.