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Journal of Clinical Microbiology, May 1998, p. 1357-1360, Vol. 36, No. 5
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Nosocomial Outbreak of Klebsiella pneumoniae Producing SHV-5 Extended-Spectrum beta -Lactamase, Originating from a Contaminated Ultrasonography Coupling Gel

Olivier Gaillot,1,2,* Christophe Maruéjouls,2 Éric Abachin,1 Fabrice Lecuru,3 Guillaume Arlet,4 Michel Simonet,2,dagger and Patrick Berche1,2

Laboratoire de Microbiologie, Faculté de Médecine Necker-Enfants Malades, 75730 Paris Cedex 15,1 Laboratoire de Bactériologie-Virologie2 and Service de Gynécologie-Obstétrique-Maternité,3 Hôpital Boucicaut, 75730 Paris Cedex 15, and Laboratoire de Microbiologie, Hôpital Saint Louis, 75475 Paris Cedex 10,4 France

Received 2 December 1997/Returned for modification 8 February 1998/Accepted 18 February 1998

Klebsiella pneumoniae resistant to ceftazidime was isolated from six adult women and two neonates hospitalized between July and November 1993 in the Department of Obstetrics and Gynecology of Boucicaut Hospital (Paris, France). The epidemiological investigation revealed a notably short delay (less than 48 h) between admission and contamination of the six adults and peripartum transmission to the neonates. The only environmental source of ceftazidime-resistant K. pneumoniae was the ultrasonography coupling gel used in the emergency room. Phenotypic (biotyping and antibiotyping) and genotypic (plasmid profile and pulsed-field gel electrophoresis) analysis of all the clinical isolates indicated the spread of a single strain. It produced SHV-5 and TEM-1 beta -lactamases, as demonstrated by isoelectric focusing and gene sequencing. The risk of cross-contamination in ultrasonography procedures is usually low and had not been associated so far with bacteria producing an extended-spectrum beta -lactamase (ESBL). Furthermore, this is the first time an epidemic of an SHV-5 ESBL-producing member of the family Enterobacteriaceae has been reported from a French hospital.

* Corresponding author. Mailing address: Laboratoire de Microbiologie, Faculté de Médecine Necker-Enfants Malades, 156 rue de Vaugirard, 75730 Paris Cedex 15, France. Phone: (33) (1) 40 61 53 77. Fax: (33) (1) 40 61 55 92. E-mail: gaillot{at}necker.fr.

dagger Present address: Laboratoire de Bactériologie, Faculté de Médecine Henri Warembourg, 59045 Lille, France.

Journal of Clinical Microbiology, May 1998, p. 1357-1360, Vol. 36, No. 5
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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