Background: The emergence of
Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases is rare. We report an occurrence of
Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases in a Chinese tertiary care hospital from November 2010 to December 2012.
Methods: The clinical characteristics of 30 patients were described. The genetic relationship of isolates was determined by pulsed-field gel electrophoresis (PFGE). Carbapenemases were detected by modified Hodge test (MHT) and polymerase chain reactions (PCRs). Amplicons were sequenced and blasted to determine the genotype.
Results: Most infected patients were from intensive care unit and had complex and serious underlying illnesses requiring mechanical ventilation. PFGE revealed that
Klebsiella pneumoniae
showed two major PFGE types. Two
Klebsiella oxytoca
had an indistinguishable PFGE pattern, while four
Enterobacter cloacae
were different strains. The sequencing studies showed
Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in the 23 infected patients. The majority of patients had infections with the carbapenemase-producing
Enterobacteriaceae (CPE) strain, most were successfully treated with a range of antibiotics and discharged.
Conclusion: It is important to maintain a high index of suspicion to screen for carbapenemase-producing
Enterobacteriaceae strains. Rapid identification of these strains and implementation of stringent procedures are the key to prevent major outbreaks in a hospital setting. Keywords:
