EXTENDED-SPECTRUM BETA-LACTAMASE-PRODUCING KLEBSIELLA-PNEUMONIAE IN ADUBLIN PEDIATRIC HOSPITAL

Klebsiella pneumoniae resistant to third-generation cephalosporins and gentamicin was isolated from two patients in a paediatric intensive c are unit within a two-week period. The double-disc diffusion test indi cated the presence of an extended-spectrum P-lactamase (ESBL). The uni t was closed to admissions, and stringent infection control procedures were implemented. Environmental screening and screening of staff and patients on the unit were commenced. Two weeks later, K. pneumoniae wi th an identical antibiogram was isolated from the urine of a patient i n a different ward. Blood-culture isolates possessed the K16 antigen, while the urine isolate was non-typeable. The isolates were shown to b e similar when banding patterns of XbaI chromosomal DNA digests were c ompared. The resistance to the extended-spectrum cephalosporins was sh own to be transferable in association with a large plasmid >98 mDa. Re sistance to gentamicin always co-transferred with Plactamase resistanc e and appeared to be encoded by the same plasmid.