Factors related to successful control of an outbreak by Klebsiella pneumonia-producing KPC-2 in an intensive care unit in Bogotá, Colombia [Factores relacionados con el control exitoso de un brote por Klebsiella pneumoniae productora de KPC-2 en una unidad de cuidado intensivo en Bogotá, Colombia]
Gualtero-Trujillo S.,Servicio de Infectologia y Epidemiologia |
Ortiz-Aroca J.,Servicio de Infectologia y Epidemiologia |
Novoa-Bernal A.,Servicio de Infectologia y Epidemiologia |
Arias-Leon G.,Servicio de Infectologia y Epidemiologia |
Silva-Monsalve E.,Servicio de Infectologia y Epidemiologia
Infectio | Year: 2016
The considerable increase in carbapenem-resistant Klebsiella pneumoniae has caused an increase in mortality and morbidity rates. The aim of this study was to describe its epidemiological and microbiological characteristics and the intervention measures that controlled an outbreak caused by K. pneumoniae-producing KPC-2 B-lactamase. Methods The study was divided into 2 periods: the first during the outbreak with the implementation of a bundle and the second a post-outbreak surveillance. We performed tests for identification and susceptibility by using an automated system, screening carbapenemases by the Modified-Hodge test, blaKPC, blaKPC-2 and NDM-1 identification by PCR and clonal relationship characterisation by PFGE. Results During the outbreak, there were 18 isolates of Klebsiella pneumoniae-producing KPC-2 in 11 patients. Three cases were confirmed as hospital-acquired infection. Of 22 isolates, 21 were positive to blaKPC by PCR (samples from patients and environment) and a clone was identified with a similarity of greater than 75%. During the post-outbreak surveillance, we did not find any new positive cultures from surfaces and there were no new colonisations. Discussion This was a successful control of an outbreak produced by a clone. The implementation of a bundle and a subsequent surveillance to monitor its fulfilment, effective communication and teamwork were crucial to inhibit propagation of the infection and to prevent an endemic behaviour post-outbreak. © 2015 ACIN.
Pelvic inflammatory disease by Actinomyces sp. in a patient with an intrauterine device: Case report [Enfermedad pélvica inflamatoria por Actinomyces sp. en paciente con dispositivo intrauterino: Reporte de un caso]
Gualtero-Trujillo S.,Servicio de Infectologia y Epidemiologia
Infectio | Year: 2016
Among the pelvic infections in women there exist those caused by anaerobic microorganisms of the genera Actinomyces. This etiology is rarely suspected, due to the few number of cases presented, thus the infection continues for long periods of time. This persistence can lead to various complications that can only be resolved with surgical procedures and prolonged antibiotic treatment. We present a case report on a 48-year old patient with a 13-year history of intrauterine device use, which we considered to be the principal risk factor. We describe the characteristics of the infection, the procedures performed, microbiological findings and the treatment, with which it was satisfactorily resolved. © 2015 ACIN.