Control of an outbreak due to orthopedic infections caused by Enterobacteriaceae producing IMP-4 or IMP-8 carbapenemases

Abstract

Objective: To investigate control of an outbreak due to orthopedic infections caused by Enterobacteriaceae producing IMP carbapenemases.

Methods: The sporadic orthopedic infections with Enterobacteriaceae producing carbapenemase (CPE) were retrospectively analyzed in a Chinese tertiary care hospital from November 2010 to September 2012.

Results: The CPE were isolated from four distinct orthopedic patients, three patients infected with Enterobacter cloacae while the other with Klebsiella oxytoca. All strains were resistant to almost all the conventional antimicrobial. The strains produced IMP-4 type detected in the two early patients, while other strains could produce IMP-8 type. All of the four patients had ever undergoing invasive surgical procedure, and three of them were given fluoroquinolones for anti-infection treatment while the other patients was treated with meropenem. Ultimately, all patients were cured and discharged, without outbreak of nosocomial infection caused by CPE.

Conclusion: Our study shows that strict infection control plays an important role in limiting dissemination of Enterobacteriaceae producing IMP carbapenemase. In addition, reasonable supporting treatment and disinfection protection seems to be more effective for the infection of strains.

Keywords: Carbapénèmase IMP; Enterobacteriaceae; IMP carbapenemase; Infection; Orthopedic; Orthopédique.