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Epidemiology and Surveillance

Detection of the KPC Gene in Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii during a PCR-Based Nosocomial Surveillance Study in Puerto Rico

Iraida E. Robledo, Edna E. Aquino, Guillermo J. Vázquez
Iraida E. Robledo
University of Puerto Rico, School of Medicine, Department of Microbiology and Medical Zoology, San Juan, Puerto Rico
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Edna E. Aquino
University of Puerto Rico, School of Medicine, Department of Microbiology and Medical Zoology, San Juan, Puerto Rico
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Guillermo J. Vázquez
University of Puerto Rico, School of Medicine, Department of Microbiology and Medical Zoology, San Juan, Puerto Rico
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  • For correspondence: guillermo.vazquez1@upr.edu
DOI: 10.1128/AAC.01633-10
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Tables

  • Table 1.

    Numbers of KPC-positive E. coli, K. pneumoniae, P. aeruginosa, and A. baumannii isolates among the total number of isolates and the multi-beta-lactam-resistant isolates

    OrganismNo. of isolatesNo. of KPC producers/total (%)
    TotalMβLRKPC producersAll isolatesMβLR isolates
    E. coli4,3292196161/4,329 (1.4)61/219 (33)
    K. pneumoniaea2,805457333333/2,805 (12)333/457 (73)
    P. aeruginosa2,4152729999/2,415 (4.1)99/272 (44)
    A. baumannii9582914141/958 (4.3)41/291 (14)
        Total10,5071,239534534/10,507 (5)534/1,239 (43)
    • ↵a P ≤ 0.05.

  • Table 2.

    Total numbers of hospitals, beds, and KPC-positive isolates by geographic region

    Geographic regionTotal no. (%) of:No. of KPC-positive isolates/total (%)
    HospitalsBedsIsolatesMβLR isolatesKPC producersE. coliK. pneumoniaeaP. aeruginosaA. baumanniiOverall
    Puerto Rico Medical Center68582,47235418019/32 (59)a101/122 (83)41/67 (61)a19/133 (14)180/354 (51)
    Metropolitan39062,371196728/52 (15)39/59 (66)18/46 (39)7/39 (18)72/196 (37)
    North24391,7062598715/73 (21)65/94 (69)3/56 (5)4/36 (11)87/259 (34)
    West23241,31695431/13 (8)26/38 (68)15/27 (56)a1/17 (6)43/95 (45)
    South25931,2991768615/35 (43)a55/75 (73)13/48 (27)3/18 (17)86/176 (49)
    Central/East24971,343159663/14 (21)47/69 (68)9/28 (32)7/48 (15)66/159 (42)
        Total173,61710,5071,239/10,507 (12)534/1,239 (43)61/219 (28)333/457(73)99/272 (36)41/291 (14)534/1239 (43)
    • ↵a P ≤ 0.05.

  • Table 3.

    Baseline clinical information on KPC-positive E. coli, K. pneumoniae K. pneumoniae, P. aeruginosa, and A. baumannii isolates

    OrganismTotal no. of KPC-positive isolatesNo. of isolates from patients of following gender:No. of isolates from following hospital unit:No. of isolates from following anatomical site:
    FaMbNRcICUGeneral wardNRRTd,hUTe,hSSTfBloodMisc.gNR
    E. coli612635013444923121070
    K. pneumoniae33316216741082121390935749422
    P. aeruginosa99465032871035221810131
    A. baumannii4118221182211647851
    Total5342522748167349181501429477674
    • ↵a F, female.

    • ↵b M, male.

    • ↵c NR, not reported.

    • ↵d RT, respiratory tract.

    • ↵e UT, urinary tract.

    • ↵f SST, skin and soft tissue.

    • ↵g Misc., miscellaneous.

    • ↵h P ≤ 0.05.

  • Table 4.

    Total numbers and percentages of isolates susceptible to selected antibioticsa

    OrganismTotal no. of KPC producersNo. of isolates susceptible/total (%)
    CeftriaxoneCefepimeImipenemPiperacillin-tazobactamAmikacinCiprofloxacinESBL
    K. pneumoniae33321/288 (7)31/300 (10)89/316 (28)7/299 (2)114/330 (35)46/332 (14)80/332 (24)
    E. coli6110/52 (19)10/51 (20)44/53 (83)24/52 (46)39/60 (65)10/60 (17)37/60 (62)
    P. aeruginosa992/92 (2)6/98 (6)6/95 (6)16/98 (16)62/95 (59)7/98 (7)NDb
    A. baumannii410/40 (0)0/40 (0)11/33 (33)2/34 (6)4/41 (10)0/41 (0)ND
    • ↵a Data, including those on ESBL detection, are from the participating hospitals' antimicrobial susceptibility reports. The susceptibility breakpoints (μg/ml) for all isolates are as follows: ≤8, cefepime; ≤4, imipenem; ≤16, amikacin; ≤1, ciprofloxacin. The susceptibility breakpoints of ceftriaxone are ≤1 μg/ml for Enterobacteriaceae and ≤8 μg/ml for P. aeruginosa and A. baumannii. The susceptibility breakpoints (μg/ml) of ceftriaxone are ≤1 and ≤8 for the Enterobacteriaceae P. aeruginosa and A. baumannii. The susceptibility breakpoints (μg/ml) of piperacillin-tazobactam are ≤64 and 4 for P. aeruginosa and ≤16 and 4 for A. baumannii.

    • ↵b ND, not done.

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Detection of the KPC Gene in Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii during a PCR-Based Nosocomial Surveillance Study in Puerto Rico
Iraida E. Robledo, Edna E. Aquino, Guillermo J. Vázquez
Antimicrobial Agents and Chemotherapy May 2011, 55 (6) 2968-2970; DOI: 10.1128/AAC.01633-10

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Detection of the KPC Gene in Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii during a PCR-Based Nosocomial Surveillance Study in Puerto Rico
Iraida E. Robledo, Edna E. Aquino, Guillermo J. Vázquez
Antimicrobial Agents and Chemotherapy May 2011, 55 (6) 2968-2970; DOI: 10.1128/AAC.01633-10
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