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Extended measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003-2004 We report the successful control of an outbreak caused by imipenem-resistant VIM-1-producing Klebsiella pneumoniae (IR-Kp) in France. This outbreak occurred in a care centre for abdominal surgery that includes a 15-bed liver intensive care unit and performs more than 130 liver transplantations per year. The index case was a patient with acute liver failure transferred from a hospital in Greece for urgent liver transplantation who was carrying IR-Kp at admission as revealed by routine culture of a rectal swab. Infection control measures were undertaken and included contact isolation and promotion of hand hygiene with alcohol-based hand rub solution. Nevertheless, secondary IR-Kp cases were identified during the six following months from 3 December 2003 to 2 June 2004. From 2 June to 21 October, extended infection control measures were set up, such as cohorting IR-Kp carriers, contact patients and new patients in distinct sections with dedicated staff, limiting ward admission, and strict control of patient transfer. They led to a rapid control of the outbreak. The global attack rate of the IR-Kp outbreak was 2.5%, 13% in liver transplant patients and 0.4% in the other patients in the care centre (p<0.005). Systematic screening for IR-Kp of all patients admitted to the care centre is still maintained to date and no secondary IR-Kp case has been detected since 2 June 2004. 15 46 2010 Euro Surveill 1560-7917 (ELECTRONIC); 1025-496X (LINKING) Anti-Bacterial Agents/pharmacology/therapeutic use Cross Infection/epidemiology/microbiology/ prevention & control Disease Outbreaks/ prevention & control Drug Resistance Bacterial Female France/epidemiology Hospital Bed Capacity N. Kassis-Chikhani F.Saliba A.Carbonne S.Neuville D.Decre C.Sengelin C.Guerin N.Gastiaburu A. Lavigne-Kriaa C.Boutelier G.Arlet D.Samuel D.Castaing E.Dussaix V.Jarlier