Characteristics and management of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in a tertiary hospital.

Abstract

BACKGROUND:

The emergence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases is rare. We report an occurrence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases in a Chinese tertiary care hospital from November 2010 to December 2012.

METHODS:

The clinical characteristics of 30 patients were described. The genetic relationship of isolates was determined by pulsed-field gel electrophoresis (PFGE). Carbapenemases were detected by modified Hodge test (MHT) and polymerase chain reactions (PCRs). Amplicons were sequenced and blasted to determine the genotype.

RESULTS:

Most infected patients were from intensive care unit and had complex and serious underlying illnesses requiring mechanical ventilation. PFGE revealed that Klebsiella pneumoniae showed two major PFGE types. Two Klebsiella oxytoca had an indistinguishable PFGE pattern, while four Enterobacter cloacae were different strains. The sequencing studies showed Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in the 23 infected patients. The majority of patients had infections with the carbapenemase-producing Enterobacteriaceae (CPE) strain, most were successfully treated with a range of antibiotics and discharged.

CONCLUSION:

It is important to maintain a high index of suspicion to screen for carbapenemase-producing Enterobacteriaceae strains. Rapid identification of these strains and implementation of stringent procedures are the key to prevent major outbreaks in a hospital setting.

• Authors: Feng Pang, Xiu-Qin Jia, Zhen-Zhu Song, Yan-Hua Li, Bin Wang, Qi-Gang Zhao, Chuan-Xin Wang, Yi Zhang, Le-Xin Wang
• Journal: African health sciences (Afr Health Sci) Vol. 16 Issue 1 Pg. 153-61 (Mar 2016) ISSN: 1729-0503 [Electronic] Uganda
• PMID: 27358627 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Bacterial Proteins
• IMP-8 enzyme
• beta-lactamase IMP-4
• beta-Lactamases
• carbapenemase

Topics

• Adult
• Aged
• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Bacterial Proteins (isolation & purification)
• Child, Preschool
• China (epidemiology)
• Electrophoresis, Gel, Pulsed-Field
• Enterobacteriaceae (enzymology, genetics)
• Enterobacteriaceae Infections (drug therapy, enzymology, genetics)
• Female
• Humans
• Infant, Newborn
• Klebsiella (enzymology, genetics)
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Polymerase Chain Reaction
• Tertiary Care Centers
• beta-Lactamases (isolation & purification)