Outbreak of SHV-5 [beta]-Lactamase-Producing Klebsiella pneumoniae in a Neonatal-Pediatric Intensive Care Unit in Spain

The objective was to analyze the beta-lactamase genes and the clonal relationship in a series of 12 clinical Klebsiella pneumoniae strains resistant to ceftazidime or cefotaxime (MIC >/=16 microg/ml) recovered in the neonatalpediatric intensive care unit (ICU) ward of a Spanish hospital during a 1-year period. TEM, SHV, CTX-M, CMY, or FOX beta-lactamase genes were analyzed by PCR and sequencing. The clonal study was performed by pulsed-field gel electrophoresis (PFGE) using XbaI. All but one of the 12 K. pneumoniae strains harbored the bla (SHV-5) gene, and the bla TEM-1a gene was also detected in one of them. These 11 strains belonged to two different clonal types: A (9 strains) and B (2 strains) and were grouped in the subtypes A(1) (6 strains), A(2), A(3), A(4), B(1), and B(2) (1 strain each). The clonal type A strains were isolated from 9 patients (in five cases from blood) during a 6-month period. The remaining K. pneumoniae strain harbored both the bla (SHV-11) + bla (CTX-M-14) genes and showed the clonal type C. A nosocomial outbreak by a SHV-5-producing multiresistant K. pneumoniae is reported in Spain in a neonatal-pediatric ICU ward. This is the first description of a K. pneumoniae harboring both the bla (SHV-11) and bla (CTX-M-14) genes in Spain.