Heat-resistant, extended-spectrum β-lactamase-producing Klebsiella pneumoniae in endoscope-mediated outbreak
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Heat-resistant, extended-spectrum β-lactamase-producing Klebsiella pneumoniae in endoscope-mediated outbreak. / Jørgensen, S.B.; Bojer, Martin Saxtorph; Boll, E.J.; Martin, Y.; Helmersen, K.; Skogstad, M.; Struve, C.
In: Journal of Hospital Infection, Vol. 93, No. 1, 2016, p. 57-62.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Heat-resistant, extended-spectrum β-lactamase-producing Klebsiella pneumoniae in endoscope-mediated outbreak
AU - Jørgensen, S.B.
AU - Bojer, Martin Saxtorph
AU - Boll, E.J.
AU - Martin, Y.
AU - Helmersen, K.
AU - Skogstad, M.
AU - Struve, C.
PY - 2016
Y1 - 2016
N2 - BackgroundWe describe an outbreak with an extended-spectrum β-lactamase-producing Klebsiella pneumoniae strain in an intensive care unit in a secondary care hospital in Norway. The outbreak source was a fibreoptic intubation endoscope in which the outbreak strain survived despite chemothermal disinfection in a decontaminator designated for such use. The genetic marker clpK, which increases microbial heat resistance, has previously been described in K. pneumoniae outbreak strains.AimTo investigate the role of clpK in biofilm formation and heat-shock stability in the outbreak strain.MethodsThe outbreak investigation was done by review of clinical records, screening of patients and culture from intubation endoscopes and bronchoscopes. Amplified fragment length polymorphism was used to identify the outbreak strain. clpK detection was performed by polymerase chain reaction, followed by mutant construction and heat-shock assays.FindingsFive patients and one intubation endoscope contained K. pneumoniae with the same amplified fragment length polymorphism pattern. The outbreak strain contained the clpK genetic marker, which rendered the strain its increased heat resistance. The survival rate of the strain grown as biofilm following heat treatment was also strongly dependent on clpK.ConclusionAlthough clpK has been associated with clinical isolates of K. pneumoniae in earlier outbreaks, this is the first time that a ClpK-producing strain has been isolated from an environmental outbreak source. Heat resistance of certain K. pneumoniae strains may facilitate survival in biofilms on medical equipment and hence increase the potential of those strains to persist and disperse in the hospital environment.
AB - BackgroundWe describe an outbreak with an extended-spectrum β-lactamase-producing Klebsiella pneumoniae strain in an intensive care unit in a secondary care hospital in Norway. The outbreak source was a fibreoptic intubation endoscope in which the outbreak strain survived despite chemothermal disinfection in a decontaminator designated for such use. The genetic marker clpK, which increases microbial heat resistance, has previously been described in K. pneumoniae outbreak strains.AimTo investigate the role of clpK in biofilm formation and heat-shock stability in the outbreak strain.MethodsThe outbreak investigation was done by review of clinical records, screening of patients and culture from intubation endoscopes and bronchoscopes. Amplified fragment length polymorphism was used to identify the outbreak strain. clpK detection was performed by polymerase chain reaction, followed by mutant construction and heat-shock assays.FindingsFive patients and one intubation endoscope contained K. pneumoniae with the same amplified fragment length polymorphism pattern. The outbreak strain contained the clpK genetic marker, which rendered the strain its increased heat resistance. The survival rate of the strain grown as biofilm following heat treatment was also strongly dependent on clpK.ConclusionAlthough clpK has been associated with clinical isolates of K. pneumoniae in earlier outbreaks, this is the first time that a ClpK-producing strain has been isolated from an environmental outbreak source. Heat resistance of certain K. pneumoniae strains may facilitate survival in biofilms on medical equipment and hence increase the potential of those strains to persist and disperse in the hospital environment.
KW - Faculty of Health and Medical Sciences
KW - clpK
KW - Extended-spectrum β-lactamase
KW - Intensive care unit
KW - Intubation endoscope
KW - Outbreak
U2 - 10.1016/j.jhin.2016.01.014
DO - 10.1016/j.jhin.2016.01.014
M3 - Journal article
VL - 93
SP - 57
EP - 62
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
SN - 0195-6701
IS - 1
ER -
ID: 165081852