Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-12-01T01:52:20.849Z Has data issue: false hasContentIssue false
  • English
  • Français

A Nursery Outbreak of Multiple-Aminoglycoside-Resistant Escherichia coli

Published online by Cambridge University Press:  02 January 2015

Robert R Gaynes ,
Diane Simpson ,
Sally A. Reeves ,
Robert C. Noble ,
Clyde Thornsberry ,
David Culver ,
James R. Allen  and
William J. Martone
Robert R Gaynes*
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
Diane Simpson
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
Sally A. Reeves
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
Robert C. Noble
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
Clyde Thornsberry
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
David Culver
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
James R. Allen
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
William J. Martone
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
*
Hospital Infections Program, CID, Centers for Disease Control, Atlanta, GA30333
Get access Rights & Permissions [Opens in a new window]

Abstract

In the neonatal intensive care unit (NICU) of one hospital, 16 infants became colonized or infected with multiply-resistant Escherichia coli (MR-E.coli) over an 8-month period. Isolates were obtained from blood, urine, and sputum of three patients and from rectal surveillance cultures of 13 patients. The one patient with the blood isolate died. A matched case-control study identified continuous feeding (nine of 16 cases vs. one of 16 controls, p ≤ 0.001) and receipt of aminoglycosides (p ≤ 0.03) as risk factors. For case-babies not exposed to continuous feeding, duration of bolus feeding was significantly greater than for their controls (cases, 22 days; controls, 7 days; p ≤ 0.02). All 16 isolates were the same serotype and were resistant to amikacin, tobramycin, kanamycin, and gentamicin. The epidemiologic investigation suggested that MR-E. coli may have spread from person-to-person on the hands of personnel and that MR-E. coli persisted in the NICU for 8 months until effective control measures were instituted.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 11 , November 1984 , pp. 519 - 524
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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.Moellering, RC: In vitro antibacterial activity of the aminoglycoside antibiotics. Rev Infect Dis 1983; 5(suppl 2):S212–S231.CrossRefGoogle Scholar
2.Balows, A, Hausler, WJ (eds): Diagnostic Procedures for Bacterial, Mycotic and Parasitic Infections. Washington, DC, American Public Health Association, 1981.Google Scholar
3.Weinstein, RA, Nathan, C, Gruensfelder, R, et al: Endemic aminoglycoside resistance in gram-negative bacilli: Epidemiology and mechanisms. J Infect Dis 1980;141:338–345.CrossRefGoogle ScholarPubMed
4.Goldmann, DA: Bacterial colonization and infection in the neonate. Am J Med 1981;70:282–284.CrossRefGoogle Scholar
5.Wormser, GP, Tatz, J, Donath, J: Endemic resistance to amikacin among hospital isolates of gram-negative bacilli: Implications for therapy. Infect Control 1983;4:93–99.CrossRefGoogle ScholarPubMed
6.Moody, MM, deJongh, CA, Schimpff, SC, et al: Long-term amikacin use. Effects on aminoglycoside susceptibility patterns of gram-negative bacilli. JAMA 1982;248:1199–1202.CrossRefGoogle ScholarPubMed
7.Price, KE, Kresel, PA, Farchione, LA, et al: Epidemiological studies of aminoglycoside resistance in the USA. J Antimicrob Chemother 1981; 8(suppl A):89–105.CrossRefGoogle Scholar
8.Davies, J, Courvalin, P: Mechanisms of resistance to aminoglycosides. Am J Med 1977;62:868–872.CrossRefGoogle ScholarPubMed
9.Weinstein, RA, Kabins, SA: Strategies for prevention and control of multiple drug-resistant nosocomial infection. Am J Med 1981;70:449–454.CrossRefGoogle ScholarPubMed