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Antimicrobial Agents and Chemotherapy, December 1998, p. 3079-3085, Vol. 42, No. 12
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Outbreak of Ceftazidime-Resistant Klebsiella pneumoniae in a Pediatric Hospital in Warsaw, Poland: Clonal Spread of the TEM-47 Extended-Spectrum beta -Lactamase (ESBL)-Producing Strain and Transfer of a Plasmid Carrying the SHV-5-Like ESBL-Encoding Gene

Marek Gniadkowski,1,* Andrzej Palucha,1 Pawel Grzesiowski,2 and Waleria Hryniewicz1

Sera & Vaccines Central Research Laboratory, 00-725 Warsaw,1 and University Children's Hospital, 00-628 Warsaw,2 Poland

Received 30 March 1998/Returned for modification 23 July 1998/Accepted 20 September 1998

In 1996 a large, 300-bed pediatric hospital in Warsaw, Poland, started a program of monitoring infections caused by extended-spectrum beta -lactamase (ESBL)-producing microorganisms. Over the first 3-month period eight Klebsiella pneumoniae isolates were identified as being resistant to ceftazidime. Six of these were found to produce the TEM-47 ESBL, which we first described in a K. pneumoniae strain recovered a year before in a pediatric hospital in Lódz, Poland, which is 140 km from Warsaw. Typing results revealed a very close relatedness among all these isolates, which suggested that the clonal outbreak in Warsaw was caused by a strain possibly imported from Lódz. The remaining two isolates expressed the SHV-5-like ESBL, which resulted from the horizontal transfer of a plasmid carrying the blaSHV gene between nonrelated strains. The data presented here exemplify the complexity of the epidemiological situation concerning ESBL producers typical for large Polish hospitals, in which no ESBL-monitoring programs were in place prior to 1995.

* Corresponding author. Mailing address: Sera & Vaccines Central Research Laboratory, ul. Chelmska 30/34, 00-725 Warsaw, Poland. Phone: (48) 22-41 33 67. Fax: (48) 22-41 29 49. E-mail: marekg{at}ibbrain.ibb.waw.pl.

Antimicrobial Agents and Chemotherapy, December 1998, p. 3079-3085, Vol. 42, No. 12
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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