Klebsiella pneumoniae blaNDM-1 carrying a class 1 integron causing a hospital outbreak in a Mexican attention center

  • Iliana Alejandra Cortés-Ortíz Laboratory of Bacteriology, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Julio Cesar Juárez-Gómez Laboratory of Bacteriology, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Concepción Cu-Quijano Laboratory of Bacteriology, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Rocio Flores-Paz Laboratory of Bacteriology, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Emilio Mariano Durán-Manuel Research Unit, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Clemente Cruz-Cruz Research Unit, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Victor Hugo Gutiérrez-Muñoz Hospital Epidemiological Surveillance Unit, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Oscar Sosa-Hernández Hospital Epidemiological Surveillance Unit, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Noé Escobar-Escamilla Instituto de Diagnóstico y Referencia Epidemiológicos "Dr. Manuel Martínez Báez", Francisco de P. Miranda, Mexico City, Mexico
  • Juan Carlos Bravata-Alcántara Molecular Diagnostic Laboratory, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Laura Delgado-Balbuena Research Unit, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Gabriela Ibáñez-Cervantes Research Unit, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
  • Juan Manuel Bello-López Research Unit, Hospital Juárez de México, Instituto Politécnico Nacional, Mexico City, Mexico
Keywords: Hospital outbreak, Klebsiella pneumoniae, blaNDM-1, class 1 integron

Abstract

Introduction: Infections acquired in hospitals are the cause of high morbidity and mortality and with the emergence of resistant bacteria, the problem is greater. The aim of this work was to determine the genetic characteristics and timeline of Klebsiella pneumoniae blaNDM-1 carrying a class 1 integron involved in an intrahospital outbreak.

Methodology: Investigation was made from the first detection of K. pneumoniae blaNDM-1, strain “466”, and the last clone “423”. 16S rRNA gene analysis showed that 466 strain and clones were related to K. pneumoniae. Extended-spectrum β-lactamases (ESBL) was detected according to the Clinical and Laboratory Standards Institute (CLSI) and real time-PCR. Typing of K. pneumoniae blaNDM-1 strains was carried by ERIC-PCR and sequencing the variable region of the integrons were performed.

Results: A cluster of six resistant isolates of K. pneumoniae blaNDM-1 was detected in intensive care unit (ICU), internal medicine (IM) and orthopedics (OT). Timeline revealed that the first bacterial identification was in ICU and the last clone in OT service. The array genetic of variable region was “IntI/aadA5-drfA17/qacEΔ1-Sul1”.

Conclusions: The evidences highlight the importance of the epidemiological surveillance of Extended-spectrum β-lactamases (ESBL) strains, as well as the need for molecular epidemiological studies to identify the routes of transmission and the contamination sources within health personnel.

Published
2021-05-31
How to Cite
1.
Cortés-Ortíz IA, Juárez-Gómez JC, Cu-Quijano C, Flores-Paz R, Durán-Manuel EM, Cruz-Cruz C, Gutiérrez-Muñoz VH, Sosa-Hernández O, Escobar-Escamilla N, Bravata-Alcántara JC, Delgado-Balbuena L, Ibáñez-Cervantes G, Bello-López JM (2021) Klebsiella pneumoniae blaNDM-1 carrying a class 1 integron causing a hospital outbreak in a Mexican attention center. J Infect Dev Ctries 15:657-664. doi: 10.3855/jidc.12996
Section
Original Articles