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An Outbreak of Extended-Spectrum β-Lactamase–Producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Pranita D. Tamma*
Affiliation:
Johns Hopkins Medical Institutions, Division of Pediatric Infectious Diseases, Baltimore, Maryland
Patrice Savard
Affiliation:
Johns Hopkins Medical Institutions, Department of Hospital Epidemiology and Infection Control, Baltimore, Maryland
Tibor Pál
Affiliation:
United Arab Emirates University, Department of Microbiology and Immunology, Al Ain, United Arab Emirates
Ágnes Sonnevend
Affiliation:
United Arab Emirates University, Department of Microbiology and Immunology, Al Ain, United Arab Emirates
Trish M. Perl
Affiliation:
Johns Hopkins Medical Institutions, Departments of Medicine, Pathology, and Epidemiology, Baltimore, Maryland
Aaron M. Milstone
Affiliation:
Johns Hopkins Medical Institutions, Division of Pediatric Infectious Diseases, Baltimore, Maryland
*
Pranita D. Tamma, MD, Johns Hopkins Medical Institutions, Division of Pediatric Infectious Diseases, 200 North Wolfe Street, Suite 3155, Baltimore, MD 21287 ([email protected])

Abstract

We present a large outbreak of ESBL-producing Klebsiella pneumoniae in a neonatal intensive care unit that resulted in 31 colonized infants, 10 invasive infections, and 5 attributable deaths over a 5-month period. Although the source of infection was unknown, overcrowding and understaffing appeared to have been aggravating factors.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012 

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References

1. Rossi, F, Baquero, F, Hsueh, PR, et al. In vitro susceptibilities of aerobic and facultatively anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). J Antimicrob Chemother 2006;58(1):205210.Google Scholar
2. Baquero, F, Hsueh, PR, Paterson, DL, et al. In vitro susceptibilities of aerobic and facultatively anaerobic gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2005 results from Study for Monitoring Antimicrobial Resistance Trends (SMART). Surg Infect (Larchmt) 2009;10(2):99104.Google Scholar
3. Bush, K. Alarming beta-lactamase-mediated resistance in multidrug-resistant Enterobacteriaceae . Curr Opin Microbiol 2010; 13(5):558564.Google Scholar
4. Qureshi, ZA, Paterson, DL, Pakstis, DL, et al. Risk factors and outcome of extended-spectrum beta-lactamase-producing Enterobacter cloacae bloodstream infections. Int J Antimicrob Agents 2011;37(1):2632.Google Scholar
5. Paterson, DL, Ko, WC, Von Gottberg, A, et al. Outcome of cephalosporin treatment for serious infections due to apparently susceptible organisms producing extended-spectrum beta-lacta-mases: implications for the clinical microbiology laboratory. J Clin Microbiol 2001;39(6):22062212.Google Scholar
6. Gudiol, C, Calatayud, L, Garcia-Vidal, C, et al. Bacteraemia due to extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) in cancer patients: clinical features, risk factors, molecular epidemiology and outcome. J Antimicrob Chemother 2010;65(2):333341.Google Scholar
7. Gastmeier, P, Loui, A, Stamm-Balderjahn, S, et al. Outbreaks in neonatal intensive care units-they are not like others. Am J Infect Control 2007;35(3):172176.Google Scholar
8. Centers for Disease Control and Prevention (CDC). 2002. Standardized molecular subtyping of foodborne bacterial pathogens by pulsed-field gel electrophoresis. Adanta, GA: CDC. http://www.cdc.gov/pulsenet/protocols.htm. Accessed November 28, 2011.Google Scholar
9. Rotimi, VO, Duerden, BI. The development of the bacterial flora in normal neonates. J Med Microbiol 1981;14(1):5162.Google Scholar
10. Harbarth, S, Sudre, P, Dharan, S, Cadenas, M, Pittet, D. Outbreak of Enterobacter cloacae related to understaffing, overcrowding, and poor hygiene practices, Infect Control Hosp Epidemiol 1999; 20(9):598603.Google Scholar