Emergence of NDM-4-producing Klebsiella pneumoniae in a Korean hospital due to a patient hospitalized in Vietnam and case review

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 25; no. 11; pp. 909 - 912
• Main Authors: Chang, Jeonghyun, Lee, Jeong-Young, Joo, Ji Yeon, Kim, Kyuri, Park, Hee-Youn, Kim, Sung-Han, Choi, Sang-Ho, Sung, Heungsup, Kim, Mi-Na
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.11.2019
• Subjects: Adult; Bacterial Proteins - metabolism; beta-Lactamases - metabolism; blaNDM-4; Carbapenemase-producing Enterobacteriaceae; Humans; Infection control; Infection Control - methods; Klebsiella Infections - diagnosis; Klebsiella Infections - microbiology; Klebsiella pneumoniae; Klebsiella pneumoniae - isolation & purification; Klebsiella pneumoniae - metabolism; Male; Republic of Korea; Vietnam; Vietnam; Republic of Korea; blaNDM-4; Carbapenemase-producing Enterobacteriaceae; Klebsiella pneumoniae; Infection control; bla(NDM-4)
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2019.04.010

NDM-4-producing Klebsiella pneumoniae (NDM-4-KP) was detected from the patient who had previously been injured and hospitalized for 5 days in Vietnam in a neurosurgical intensive care unit (NSICU) of a Korean tertiary-care hospital in December 2016. He admitted with ventilator-associated pneumonia and NDM-4-KP was isolated, which was subsequently detected in two other NSICU patients. All NDM-4-KP isolates from patient and environmental surveillance cultures were sequence type 11. Colonization of three patients persisted for 5–12 months. Dedicated environmental cleaning was added to single room isolation of NDM-4-KP patients and universal chlorhexidine bathing, and no further transmission of NDM-4-KP occurred. This is the first report of NDM-4-KP in a Korean hospital where a patient with a history of hospitalization abroad was the index case initiating an outbreak involving three patients. The spread of newly introduced CPE was controlled using a bundle of infection control.