A small outbreak of third generation cephem-resistant Citrobacter freundii infection on a surgical ward.

作者：Toshi Nada, Hisashi Baba, Kumiko Kawamura, Teruko Ohkura, Keizo Torii, Michio Ohta · 发表于：PubMed · 年份：2004 · 被引用次数：37 · 研究领域：Antibiotic Resistance in Bacteria、Enterobacteriaceae and Cronobacter Research、Infections and bacterial resistance

*Corresponding author: Mailing address: Department of Clinical Laboratory, Nagoya University Hospital, Tsurumaicho 65, Showa-ku, Nagoya 466-8560, Japan. Tel: +81-52-744-2614, Fax: +81-52-744-2613, E-mail: t-nada@med.nagoya-u.ac.jp Citrobacter freundii is a member of family Enterobacteriaceae and has been associated with nosocomial infections in the urinary, respiratory, and biliary tracts of debilitated hospital patients. C. freundii has an inducible chromosomally encoded cephalosporinase that can inactivate cephamycins and cephalosporins. However, most clinical isolates are sensitive to new third generation cephems and carbapenems. We report here a small outbreak of infection caused by third generation cephem-resistant C. freundii on a surgical ward of a university hospital in 2002. We identified four patients with biliary infection and two carrier patients during July and October. All of the infection cases (patients A, B, E, and F) and one colonization case (patient G) underwent surgical procedures prior to the isolation of resistant C. freundii (Table 1). C. freundii were isolated from bile, wound gauze, ascites, pus, and/or feces of these patients. Epidemiological study using pulsed-field gel electrophoresis (PFGE) revealed that two different PFGE types of strains were involved in the outbreak; PFGE patterns of lanes 1, 2, 3, and 4 were indistinguishable from each other, and the patterns of lanes 5 and 6 were likewise identical (Fig. 1). These types were tentatively desi...