Outbreak of Klebsiella pneumoniae Carbapenemase-Producing Citrobacter freundii at a Tertiary Acute Care Facility in Miami, Florida

Adriana Jiménez, Jose G Castro, Luisa Munoz-Price, Dennise De Pascale, Luis Shimose, Mustapha M. Mustapha, Caressa N. Spychala, Roberta T. Mettus, Vaughn S. Cooper, Yohei Doi

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7 Scopus citations

Abstract

OBJECTIVE To describe the investigation and control of a rare cluster of Klebsiella pneumoniae carbapenemase-producing Citrobacter freundii in a hospital in southern Florida. METHODS An epidemiologic investigation, review of infection prevention procedures, and molecular studies including whole genome sequencing were conducted. RESULTS An outbreak of K. pneumoniae carbapenemase-3-producing C. freundii was identified at a tertiary hospital in Florida in 2014. Of the 6 cases identified, 3 occurred in the same intensive care unit and were caused by the same clone. For 2 of the 3 remaining cases, the isolates had low carbapenem minimum inhibitory concentrations and were unrelated by whole genome sequencing. As a response to the outbreak, supplementary environmental cleaning was implemented, including closure and terminal cleaning of the unit where the 3 cases clustered, in addition to the infection control bundle already in place at the time. No further cases were identified after these additional interventions. CONCLUSIONS Although C. freundii is not a species that commonly demonstrates carbapenem resistance, our findings suggest that carbapenemase-producing C. freundii may be underdetected even when active surveillance is in place and has a potential to cause hospital outbreak.

Original languageEnglish (US)
Pages (from-to)320-326
Number of pages7
JournalInfection Control and Hospital Epidemiology
Volume38
Issue number3
DOIs
StatePublished - Mar 1 2017

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ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Jiménez, A., Castro, J. G., Munoz-Price, L., De Pascale, D., Shimose, L., Mustapha, M. M., Spychala, C. N., Mettus, R. T., Cooper, V. S., & Doi, Y. (2017). Outbreak of Klebsiella pneumoniae Carbapenemase-Producing Citrobacter freundii at a Tertiary Acute Care Facility in Miami, Florida. Infection Control and Hospital Epidemiology, 38(3), 320-326. https://doi.org/10.1017/ice.2016.273