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In 2011, 18 patients at the National Institutes of Health Clinical Center were colonized with or infected by carbapenemase-producing Klebsiella pneumoniae; transmission among the patients was subsequently characterized through use of epidemiologic and genomic analyses. Following this outbreak, investigators continued to conduct active surveillance for carbapenem-resistant Enterobacteriaceae (CRE) in the center and in patients admitted to it. During 2012 and 2013, they identified 10 additional patients in the center (and 2 who had previously been treated there but were receiving care at outside institutions) who were colonized with CRE; they also found CRE in six environmental samples.
Previous genomic analyses of antibiotic-resistant bacteri…