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

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.

• Authors: Livia Helena Justo-da-Silva, Andrea Nunes De-Azeredo, Arnaldo Costa Bueno, Lara Feital Montezzi, Maria Beatriz Gerardin Poirot Leobons, Maria Silvana Alves, Patrícia de Souza Inhaquite, Rosana Rangel Santos, Valéria Brígido Carvalho Girão, Antônio José Ledo Alves da Cunha, Carmem Lucia Pessoa-Silva, Renata Cristina Picão, Cristina Barroso Hofer, Guilherme Santoro-Lopes, Lee Woodland Riley, Beatriz Meurer Moreira
• Journal: Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] (Braz J Microbiol) Vol. 50 Issue 4 Pg. 935-942 (Oct 2019) ISSN: 1678-4405 [Electronic] Brazil
• PMID: 31401781 (Publication Type: Journal Article)

Chemical References

• Bacterial Proteins
• beta-Lactamases

Topics

• Bacterial Proteins (genetics, metabolism)
• Cross Infection (microbiology)
• Female
• Genetic Variation
• Genotype
• Humans
• Infant
• Infant, Newborn
• Intensive Care Units, Neonatal (statistics & numerical data)
• Klebsiella Infections (microbiology)
• Klebsiella pneumoniae (classification, genetics, isolation & purification)
• Male
• Multilocus Sequence Typing
• Prospective Studies
• Urban Population
• beta-Lactamases (genetics, metabolism)