Hostname: page-component-5f745c7db-nc56l Total loading time: 0 Render date: 2025-01-06T23:43:11.375Z Has data issue: true hasContentIssue false
  • English
  • Français

An Outbreak of Gentamicin-Resistant Enterobacter cloacae Infections in a Pediatric Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Edwin L. Anderson  and
J. Patrick Hieber
Edwin L. Anderson*
Affiliation:
Department of Pediatrics, Southwestern Medical School, University of Texas Health Science Center at Dallas, Dallas, Texas
J. Patrick Hieber
Affiliation:
Department of Pediatrics, Southwestern Medical School, University of Texas Health Science Center at Dallas, Dallas, Texas
*
3110 MacCorkle Avenue, S.E., Department of Pediatrics, West Virginia University Medical Center, Charleston Division, Charleston, WV 25304
Get access Rights & Permissions [Opens in a new window]

Abstract

The intensive care unit at Children's Medical Center in Dallas is a medical-surgical unit that cares for pediatric patients of all ages. In 1978 an outbreak of infections occurred that was caused by a gentamicin-resistant strain of Enterobacter cloacae. Thirty of the 34 patients involved in the outbreak were neonates. Six patients developed bacteremia, five of them neonates. The neonates who became infected were significantly smaller (> 1500 g) and more premature (< 35 weeks) than control patients. Neonates with bacteremia had a significantly higher incidence of congenital anomalies. In a multi-specialty pediatric intensive care unit newborn infants were the group of patients at high risk for nosocomial infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 4 , Issue 3 , May/June 1983 , pp. 148 - 152
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1983

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Thoburn, R, Fekety, FR, Cluff, LE, et al: Infections acquired by hospitalized patients: An analysis of the overall problem. Arch Intern Med 1968; 121:1–10.CrossRefGoogle ScholarPubMed
2.Gardner, P, Carles, DG: Infections acquired in a pediatric hospital. J Pediatr 1972; 81:1205–1210.CrossRefGoogle Scholar
3.Siegel, JD, McCracken, GH: Sepsis neonatorum. N Engl J Med 1981; 304:642–647.CrossRefGoogle ScholarPubMed
4.Hemming, VG, Overall, JC, Britt, MR: Nosocomial infections in a newborn intensive care unit: Results of forty-one months of surveillance. N Engl J Med 1976; 294:1310–1316.CrossRefGoogle Scholar
5.Siegel, JD, McCracken, GH, Threlkeld, N, et al: Single dose penicillin prophylaxis against group B streptococcal infections. N Engl J Med 1980; 303:769–775.CrossRefGoogle ScholarPubMed
6.Mayhall, CG, Lamb, VA, Gayle, WE, et al: Enterobacter cloacae septicemia in a burn center: Epidemiology and control of an outbreak. J Infect Dis 1979; 139:166–171.CrossRefGoogle Scholar
7.Cook, LN, Davis, RS, Stover, BH: Outbreak of amikacin-resistant Enterobacteriaceae in an intensive care nursery. Pediatrics 1980; 65:264–268.CrossRefGoogle Scholar
8.Mayhall, CG, Lamb, VA, Bitar, CM, et al: Nosocomial Klebsiella infection in a neonatal unit: Identification of risk factors for gastrointestinal colonization. Infect Control 1980; 1:239–246.CrossRefGoogle Scholar
9.Parry, MF, Hutchinson, JH, Brown, NA, et al: Gram-negative sepsis in neonates: A nursery outbreak due to hand carriage of Citrobacter diversus. Pediatrics 1980; 65:1105–1109.CrossRefGoogle ScholarPubMed
10.Eisenach, KD, Reber, RM, Eitzman, DV, et al: Nosocomial infections due to kanamycin-resistant, R-factor carrying enteric organisms in an intensive care nursery. Pediatrics 1972; 50:395–402.CrossRefGoogle Scholar
11.Gardner, P, Bennett, JV, Burke, JP, et al: Nosocomial management of resistant gram-negative bacilli. J Infect Dis 1980; 141:415–417.CrossRefGoogle Scholar
12.Sprunt, K, Leidy, G, Redman, W: Abnormal colonization of neonates in an intensive care unit: Means of identifying neonates at risk of infection. Pediatr Res 1978; 12:998–1002.CrossRefGoogle Scholar
13.Boyle, R, Nelson, JS, Stonestreet, BS, et al: Alterations in stool flora resulting from oral kanamycin prophylaxis of necrotizing enterocolitis. J Pediatr 1978; 93:857–861.CrossRefGoogle ScholarPubMed
14.Franco, JA, Eitzman, DV, Baer, H: Antibiotic usage and microbial resistance in an intensive care nursery. Am J Dis Child 1973; 126:318–321.Google Scholar
15.Goldmann, DA, Leclair, J, Macone, A: Bacterial colonization of neonates admitted to an intensive care environment. J Pediatr 1978; 93:288–293.CrossRefGoogle Scholar
16.Howard, JB, McCracken, GH: Reappraisal of kanamycin usage in neonates. J Pediatr 1975; 86:949–956.CrossRefGoogle ScholarPubMed
17.Squire, E, Favara, B, Todd, J: Diagnosis of neonatal bacterial infection: Hematologic and pathologic findings of fatal and nonfatal cases. Pediatrics 1979; 64:60–64.CrossRefGoogle ScholarPubMed