被污染的呼吸管：一次由携带SHV-2和CTX-M-15 ESBL的肺炎克雷柏菌的暴发感染

David

Journal of Hospital Infection
Volume 72, Issue 1, May 2009, Pages 23-29
Role of contaminated aspiration tubes in nosocomial outbreak of Klebsiella pneumoniae producing SHV-2 and CTX-M-15 extended-spectrum β-lactamases
被污染的呼吸管：一次由携带SHV-2和CTX-M-15 ESBL的肺炎克雷柏菌的暴发感染
F. Randrianirinaa, S. Vedyb, D. Rakotovaoc, C.-E. Ramarokotoa, H. Ratsitohainad, J.F. Caroda, E. Ratsimaa, M. Morillonb and A. Talarmina, ,

aInstitut Pasteur de Madagascar, Antananarivo, Madagascar

bLaboratoire de Microbiologie, Hôpital Lavéran, Marseille, France

cService de néo-natalalogie, Hôpital CENHOSOA, Antananarivo, Madagascar

dHôpital mere-enfant, Tsaralalana, Antananarivo Madagascar


Received 23 November 2008;  accepted 4 February 2009.  Available online 17 March 2009.

Summary
Klebsiella pneumoniae resistant to ceftazidime was isolated from ten neonates hospitalised between February and March 2006 in two Antananarivo hospitals, Madagascar. The main environmental source, for one hospital in particular, was the liquid used to rinse aspiration tubes in the paediatric wards. The risk of contamination from aspiration tubes is very high in the hospitals of Antananarivo since tap water used to rinse the tubes is not regularly changed. Phenotypical (biotyping and antibiotyping) and genotypical (pulsed-field gel electrophoresis) analysis of all the clinical isolates indicated that nine cases were due to a single clone. This clone carried the genes encoding SHV-2 and CTX-M-15 β-lactamases. This is the first description of an epidemic due to an ESBL-producing member of the family Enterobacteriaceae in Malagasy hospitals.

Keywords: Aspiration tubes; CTX-M15; Extended-spectrum β-lactamases; Nosocomial infection; Klebsiella pneumoniae; SHV-2