Intra- and Extra-Hospital Dissemination of IMP-22-Producing Klebsiella pneumonia e in Northern Portugal: The Breach of the Hospital Frontier Toward the Community

葡萄牙北部地区产生 IMP-22 的肺炎克雷伯菌在医院内外的传播:医院边界向社区的突破

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作者:Daniela Gonçalves, Pedro Cecílio, Alberta Faustino, Carmen Iglesias, Fernando Branca, Alexandra Estrada, Helena Ferreira

Abstract

The emergence of infections (and colonization) with Enterobacteriaceae-producing carbapenemases is a threatening public health problem. In the last decades, we watched an isolated case becoming a brutal outbreak, a sporadic description becoming an endemic problem. The present study aims to highlight the dissemination of IMP-22-producing Klebsiella pneumoniae in the North of Portugal, through the phenotypic and genotypic characterization of isolates collected from hospitalized patients (n=5) and out-patients of the emergency ward of the same acute care hospital (n=2), and isolates responsible for the intestinal colonization of residents in a Long-Term Care Facility (n=4). Pulsed-field gel electrophoresis (PFGE) results, associated with conjugation experiments pointed to a pattern of both vertical and horizontal dissemination. Overall, and complementing other studies that give relevance to IMP-22-producing K. pneumoniae in the clinical settings, here we show for the first time the public health threatening breach of the hospital frontier of this resistance threat, toward the community.

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