Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization

We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype includi...
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Autor*in:	C. Marquez [verfasserIn] A. Ingold [verfasserIn] N. Echeverría [verfasserIn] A. Acevedo [verfasserIn] R. Vignoli [verfasserIn] V. García-Fulgueiras [verfasserIn] J. Viroga [verfasserIn] O. Gonzalez [verfasserIn] V. Odizzio [verfasserIn] K. Etulain [verfasserIn] E. Nuñez [verfasserIn] H. Albornoz [verfasserIn] G. Borthagaray [verfasserIn] A. Galiana [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2014

Schlagwörter:	Antibiotic resistance infection control KPC

Übergeordnetes Werk:	In: New Microbes and New Infections - Elsevier, 2015, 2(2014), 3, Seite 58-63
Übergeordnetes Werk:	volume:2 ; year:2014 ; number:3 ; pages:58-63

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1002/nmi2.40

Katalog-ID:	DOAJ072186070

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520			\|a We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination.
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allfields_unstemmed	10.1002/nmi2.40 doi (DE-627)DOAJ072186070 (DE-599)DOAJc6f72467e1904c939df46bef6474ea1c DE-627 ger DE-627 rakwb eng RC109-216 C. Marquez verfasserin aut Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination. Antibiotic resistance infection control KPC Infectious and parasitic diseases A. Ingold verfasserin aut N. Echeverría verfasserin aut A. Acevedo verfasserin aut R. Vignoli verfasserin aut V. García-Fulgueiras verfasserin aut J. Viroga verfasserin aut O. Gonzalez verfasserin aut V. Odizzio verfasserin aut K. Etulain verfasserin aut E. Nuñez verfasserin aut H. Albornoz verfasserin aut G. Borthagaray verfasserin aut A. Galiana verfasserin aut In New Microbes and New Infections Elsevier, 2015 2(2014), 3, Seite 58-63 (DE-627)776632434 (DE-600)2750179-6 20522975 nnns volume:2 year:2014 number:3 pages:58-63 https://doi.org/10.1002/nmi2.40 kostenfrei https://doaj.org/article/c6f72467e1904c939df46bef6474ea1c kostenfrei http://www.sciencedirect.com/science/article/pii/S2052297514500492 kostenfrei https://doaj.org/toc/2052-2975 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 2 2014 3 58-63
allfieldsGer	10.1002/nmi2.40 doi (DE-627)DOAJ072186070 (DE-599)DOAJc6f72467e1904c939df46bef6474ea1c DE-627 ger DE-627 rakwb eng RC109-216 C. Marquez verfasserin aut Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination. Antibiotic resistance infection control KPC Infectious and parasitic diseases A. Ingold verfasserin aut N. Echeverría verfasserin aut A. Acevedo verfasserin aut R. Vignoli verfasserin aut V. García-Fulgueiras verfasserin aut J. Viroga verfasserin aut O. Gonzalez verfasserin aut V. Odizzio verfasserin aut K. Etulain verfasserin aut E. Nuñez verfasserin aut H. Albornoz verfasserin aut G. Borthagaray verfasserin aut A. Galiana verfasserin aut In New Microbes and New Infections Elsevier, 2015 2(2014), 3, Seite 58-63 (DE-627)776632434 (DE-600)2750179-6 20522975 nnns volume:2 year:2014 number:3 pages:58-63 https://doi.org/10.1002/nmi2.40 kostenfrei https://doaj.org/article/c6f72467e1904c939df46bef6474ea1c kostenfrei http://www.sciencedirect.com/science/article/pii/S2052297514500492 kostenfrei https://doaj.org/toc/2052-2975 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 2 2014 3 58-63
allfieldsSound	10.1002/nmi2.40 doi (DE-627)DOAJ072186070 (DE-599)DOAJc6f72467e1904c939df46bef6474ea1c DE-627 ger DE-627 rakwb eng RC109-216 C. Marquez verfasserin aut Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination. Antibiotic resistance infection control KPC Infectious and parasitic diseases A. Ingold verfasserin aut N. Echeverría verfasserin aut A. Acevedo verfasserin aut R. Vignoli verfasserin aut V. García-Fulgueiras verfasserin aut J. Viroga verfasserin aut O. Gonzalez verfasserin aut V. Odizzio verfasserin aut K. Etulain verfasserin aut E. Nuñez verfasserin aut H. Albornoz verfasserin aut G. Borthagaray verfasserin aut A. Galiana verfasserin aut In New Microbes and New Infections Elsevier, 2015 2(2014), 3, Seite 58-63 (DE-627)776632434 (DE-600)2750179-6 20522975 nnns volume:2 year:2014 number:3 pages:58-63 https://doi.org/10.1002/nmi2.40 kostenfrei https://doaj.org/article/c6f72467e1904c939df46bef6474ea1c kostenfrei http://www.sciencedirect.com/science/article/pii/S2052297514500492 kostenfrei https://doaj.org/toc/2052-2975 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 2 2014 3 58-63
language	English
source	In New Microbes and New Infections 2(2014), 3, Seite 58-63 volume:2 year:2014 number:3 pages:58-63
sourceStr	In New Microbes and New Infections 2(2014), 3, Seite 58-63 volume:2 year:2014 number:3 pages:58-63
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Antibiotic resistance infection control KPC Infectious and parasitic diseases
isfreeaccess_bool	true
container_title	New Microbes and New Infections
authorswithroles_txt_mv	C. Marquez @@aut@@ A. Ingold @@aut@@ N. Echeverría @@aut@@ A. Acevedo @@aut@@ R. Vignoli @@aut@@ V. García-Fulgueiras @@aut@@ J. Viroga @@aut@@ O. Gonzalez @@aut@@ V. Odizzio @@aut@@ K. Etulain @@aut@@ E. Nuñez @@aut@@ H. Albornoz @@aut@@ G. Borthagaray @@aut@@ A. Galiana @@aut@@
publishDateDaySort_date	2014-01-01T00:00:00Z
hierarchy_top_id	776632434
id	DOAJ072186070
language_de	englisch
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callnumber-first	R - Medicine
author	C. Marquez
spellingShingle	C. Marquez misc RC109-216 misc Antibiotic resistance misc infection control misc KPC misc Infectious and parasitic diseases Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization
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topic_title	RC109-216 Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization Antibiotic resistance infection control KPC
topic	misc RC109-216 misc Antibiotic resistance misc infection control misc KPC misc Infectious and parasitic diseases
topic_unstemmed	misc RC109-216 misc Antibiotic resistance misc infection control misc KPC misc Infectious and parasitic diseases
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title	Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization
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title_full	Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization
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author_browse	C. Marquez A. Ingold N. Echeverría A. Acevedo R. Vignoli V. García-Fulgueiras J. Viroga O. Gonzalez V. Odizzio K. Etulain E. Nuñez H. Albornoz G. Borthagaray A. Galiana
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title_sort	emergence of kpc-producing klebsiella pneumoniae in uruguay: infection control and molecular characterization
callnumber	RC109-216
title_auth	Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization
abstract	We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination.
abstractGer	We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination.
abstract_unstemmed	We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination.
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title_short	Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization
url	https://doi.org/10.1002/nmi2.40 https://doaj.org/article/c6f72467e1904c939df46bef6474ea1c http://www.sciencedirect.com/science/article/pii/S2052297514500492 https://doaj.org/toc/2052-2975
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author2Str	A. Ingold N. Echeverría A. Acevedo R. Vignoli V. García-Fulgueiras J. Viroga O. Gonzalez V. Odizzio K. Etulain E. Nuñez H. Albornoz G. Borthagaray A. Galiana
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Marquez</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2014</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and β-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Antibiotic resistance</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">infection control</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">KPC</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Infectious and parasitic diseases</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">A. Ingold</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">N. Echeverría</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">A. Acevedo</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">R. Vignoli</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">V. García-Fulgueiras</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">J. Viroga</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">O. Gonzalez</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">V. Odizzio</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">K. Etulain</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">E. Nuñez</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">H. Albornoz</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">G. Borthagaray</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">A. Galiana</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">New Microbes and New Infections</subfield><subfield code="d">Elsevier, 2015</subfield><subfield code="g">2(2014), 3, Seite 58-63</subfield><subfield code="w">(DE-627)776632434</subfield><subfield code="w">(DE-600)2750179-6</subfield><subfield code="x">20522975</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:2</subfield><subfield code="g">year:2014</subfield><subfield code="g">number:3</subfield><subfield code="g">pages:58-63</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.1002/nmi2.40</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield 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Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization

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