# Rapid Response and Containment of an NDM-Producing Klebsiella Pneumoniae Outbreak in a Hematology Ward: Case Study from an Italian Hospital

## TL;DR

This paper reports a successful containment of an NDM-producing Klebsiella pneumoniae outbreak in an Italian hospital's hematology ward through rapid infection control measures.

## Contribution

The study presents the first reported outbreak of NDM-producing Klebsiella pneumoniae in an Italian hematology ward and demonstrates effective containment strategies.

## Key findings

- A multidisciplinary approach containing the outbreak within three weeks after the last case was identified.
- Active surveillance and microbiological screening identified four patients with NDM-producing Klebsiella pneumoniae.
- IPC measures such as enhanced cleaning, isolation, and hand hygiene protocols were critical for containment.

## Abstract

Antimicrobial resistance (AMR) constitutes a critical threat to global public health, with carbapenem-resistant Enterobacterales (CRE) presenting significant challenges due to their resistance to last-line antibiotics. Among these, New Delhi metallo-beta-lactamase (NDM)-producing Klebsiella pneumoniae (KP) is of particular concern. This study describes an outbreak of NDM-producing KP in the hematology unit of the University Hospital of Verona, Italy. This represents the second reported hospital outbreak of this strain in Italy, and the first to occur within a hematology ward. The outbreak involved four patients, all of whom were identified through active surveillance and microbiological screening. In response, a multidisciplinary team implemented a series of infection prevention and control (IPC) measures, which included enhanced environmental cleaning, strict hand hygiene protocols, patient isolation, and the development of a tailored IPC checklist. The outbreak was effectively contained within three weeks following the identification of the last case. This outcome underscores the importance of rapid and coordinated responses to NDM-producing KP outbreaks. This case study emphasizes the necessity of robust IPC protocols, rapid intervention, and continuous staff education in mitigating the spread of multidrug-resistant pathogens in healthcare settings. It further highlights the urgent need for healthcare systems to be adequately prepared and resilient in addressing the growing threat of AMR.