caa a22 4500 606157336 CHVBK 20210128100613.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s10096-015-2401-2 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2401-2 An outbreak of colistin-resistant Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae in the Netherlands (July to December 2013), with inter-institutional spread [Elektronische Daten] [V. Weterings, K. Zhou, J. Rossen, D. van Stenis, E. Thewessen, J. Kluytmans, J. Veenemans] We describe an outbreak of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-KP) ST258 that occurred in two institutions (a hospital and a nursing home) in the Netherlands between July and December 2013. In total, six patients were found to be positive for KPC-KP. All isolates were resistant to colistin and exhibited reduced susceptibility to gentamicin and tigecycline. In all settings, extensive environmental contamination was found. Whole genome sequencing revealed the presence of bla KPC-2 and bla SHV-12 genes, as well as the close relatedness of patient and environmental isolates. In the hospital setting, one transmission was detected, despite contact precautions. After upgrading to strict isolation, no further spread was found. After the transfer of the index patient to a nursing home in the same region, four further transmissions occurred. The outbreak in the nursing home was controlled by transferring all KPC-KP-positive residents to a separate location outside the nursing home, where a dedicated nursing team cared for patients. This outbreak illustrates that the spread of pan-resistant Enterobacteriaceae can be controlled, but may be difficult, particularly in long-term care facilities. It, therefore, poses a major threat to patient safety. Clear guidelines to control reservoirs in and outside the hospitals are urgently needed. Springer-Verlag Berlin Heidelberg, 2015 Weterings V. Laboratory for Microbiology and Infection Control, Amphia Hospital, P.O. Box 90158, 4800 RK, Breda, The Netherlands aut Zhou K. Molecular Unit, Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut Rossen J. Molecular Unit, Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut van Stenis D. De Riethorst Stromenland, Geertruidenberg, The Netherlands aut Thewessen E. De Riethorst Stromenland, Geertruidenberg, The Netherlands aut Kluytmans J. Laboratory for Microbiology and Infection Control, Amphia Hospital, P.O. Box 90158, 4800 RK, Breda, The Netherlands aut Veenemans J. Laboratory for Microbiology and Infection Control, Amphia Hospital, P.O. Box 90158, 4800 RK, Breda, The Netherlands aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/8(2015-08-01), 1647-1655 0934-9723 34:8<1647 2015 34 10096 https://doi.org/10.1007/s10096-015-2401-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2401-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Weterings V. Laboratory for Microbiology and Infection Control, Amphia Hospital, P.O. Box 90158, 4800 RK, Breda, The Netherlands aut NATIONALLICENCE 700 1- Zhou K. Molecular Unit, Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Rossen J. Molecular Unit, Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut NATIONALLICENCE 700 1- van Stenis D. De Riethorst Stromenland, Geertruidenberg, The Netherlands aut NATIONALLICENCE 700 1- Thewessen E. De Riethorst Stromenland, Geertruidenberg, The Netherlands aut NATIONALLICENCE 700 1- Kluytmans J. Laboratory for Microbiology and Infection Control, Amphia Hospital, P.O. Box 90158, 4800 RK, Breda, The Netherlands aut NATIONALLICENCE 700 1- Veenemans J. Laboratory for Microbiology and Infection Control, Amphia Hospital, P.O. Box 90158, 4800 RK, Breda, The Netherlands aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/8(2015-08-01), 1647-1655 0934-9723 34:8<1647 2015 34 10096