Extensive colonization with carbapenemase-producing microorganisms in Romanian burn patients: infectious consequences from the Colectiv fire disaster

L.E. Pirii, A.W. Friedrich, J.W.A. Rossen, W. Vogels, G.I.J.M. Beerthuizen, M.K. Nieuwenhuis, A.M.D. Kooistra-Smid, E. Bathoorn

Research output: Contribution to journalArticleAcademicpeer-review


Health care of severe burn patients is highly specialized and may require international patient transfer. Burn patients have an increased risk of developing infections. Patients that have been hospitalized in countries where carbapenemase-producing microorganisms (CPMO) are endemic may develop infections that are difficult to treat. In addition, there is a risk on outbreaks with CPMOs in burn centers. This study underlines that burn patients may extensively be colonized with CPMOs, and it provides best practice recommendations regarding clinical microbiology and infection control. We evaluated CPMO-carriage and wound colonization in a burn patient initially treated in Romania, and transported to the Netherlands. The sequence types and acquired beta-lactamase genes of highly-resistant microorganisms were derived from next generation sequencing data. Next, we searched literature for reports on CPMOs in burn patients. Five different carbapenemase-producing isolates were cultured: two unrelated OXA-48-producing Klebsiella pneumoniae isolates, OXA-23-producing Acinetobacter baumanii, OXA-48-producing Enterobacter cloacae, and NDM-1-producing Providencia stuartii. Also, multi-drug resistant Pseudomonas aeruginosa isolates were detected. Among the sampling sites, there was high variety in CPMOs. We found 46 reports on CPMOs in burn patients. We listed the epidemiology of CPMOs by country of initial treatment, and summarized recommendations for care of these patients based on these reports and our study.

Original languageEnglish
Pages (from-to)175-183
Number of pages9
JournalEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
Issue number1
Publication statusPublished - 23 Oct 2017
Externally publishedYes


  • acinetobacter baumannii/drug effects
  • anti-bacterial agents/therapeutic use
  • bacterial proteins/metabolism
  • burns/microbiology
  • colistin/therapeutic use
  • disasters
  • enterobacter cloacae/drug effects
  • humans
  • kanamycin/therapeutic use
  • klebsiella pneumoniae/drug effects
  • linezolid/therapeutic use
  • microbial sensitivity tests
  • Netherlands
  • penicillanic acid/analogs & derivatives
  • piperacillin/therapeutic use
  • piperacillin, tazobactam drug combination
  • providencia/drug effects
  • pseudomonas aeruginosa/drug effects
  • Romania
  • silver sulfadiazine/therapeutic use
  • beta-lactamases/metabolism


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