Gram-negative bacteria that produce carbapenemases causing death attributed to recent foreign hospitalization.
Antimicrob Agents Chemother. 2013 Apr 22;
Authors: Ahmed-Bentley J, Chandran AU, Joffe AM, French D, Peirano G, Pitout JD
Overseas travel, as a risk factor for the acquisition of infections due to antimicrobial resistant organisms, has recently been described for carbapenemase-producing Gram negative bacteria. Multi-resistant Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumannii were isolated from a wound of a Canadian patient with recent history of hospitalization in India. This resulted in the initiation of outbreak management that included surveillance cultures. Epidemiological and molecular investigations showed that NDM-1 producing K. pneumoniae ST16 and OXA-23-producing A. baumannii ST10 were transmitted to 5 other patients resulting in the colonization of 4 patients and the death of one patient due to septic shock caused by the OXA-23-producing A. baumannii. The high rate of false positivity of the screening cultures resulted in additional workload and increased costs for infection control and the clinical laboratory. We believe this is the first report that described infection with carbapenemase-producing Gram negative bacteria resulting in death attributed to a patient with recent foreign hospitalization. We recommend routine rectal and wound screening for colonization of multi-resistant bacteria in patients that have recently been admitted to hospitals outside Canada.
PMID: 23612195 [PubMed - as supplied by publisher]