Successful control of a large outbreak of colonization and infection by carbapenem-resistant klebsiella pneumoniae carbapenemase producer in ill neonates
CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoTrabalho de Conclusão de Curso (Graduação)Failures in prevention and control measures in Neonatal Intensive Care Units (NICUs) facilitate the transmission of microorganisms like Klebsiella pneumoniae, causing outbreaks of colonization and invasive infections in neonates. Objective: We describe a large nosocomial outbreak of carbapenemase-producing K. pneumoniae in the neonatal unit of a university hospital in Brazil. Methods: Between July 2023 and February 2024, carbapenem-resistant K. pneumoniae (CRKP) samples were identified and tested for antimicrobial susceptibility using an automated identification and susceptibility testing system. The blaKPC, blaNDM, and blaCTXM-Gp-1 genes were investigated by polymerase chain reaction (PCR), and clonality was explored by pulsed-field gel electrophoresis (PFGE). Results: Thirty-six patients with CRKP were identified. 72.2% (26/36) were colonized, 33.3% (12/36) had infections, and 5.5% (2/36) had both. 37.5% (6/16) of the isolates harbored the blaKPC gene, 6.25% (1/16) blaNDM, and 12.5% (2/16) blaCTXM-Gp-1. Genotyping revealed five distinct PFGE profiles. Among the colonization samples, two clones were predominant: clone A with five isolates and clone C with six isolates. Conclusion: This study described a large nosocomial outbreak of carbapenemase-producing K. pneumoniae in the neonatal unit of a university hospital in Brazil. Although this outbreak was severe, spreading through the hands of healthcare professionals, it also highlights the potential of the infection control system to manage the outbreak
