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Association Between Climate and Enterobacter Colonization in Swedish Neonatal Units

Published online by Cambridge University Press:  21 June 2016

Birgitta A. Fryklund*
Affiliation:
Swedish Institute for Infectious Disease Control, Stockholm, Sweden
Kjell Tullus
Affiliation:
Department of Pediatrics, St. Göran's Children's Hospital, Karolinska Znstitute, Stockholm, Sweden
Lars G. Burman
Affiliation:
Swedish Institute for Infectious Disease Control, Stockholm, Sweden
*
Swedish Institute for Infectious Disease Control, S-105 21 Stockholm, Sweden

Abstract

Objective:

To study risk factors for the highly variable local colonization rates with unrelated Enterobacter species strains previously found in 22 Swedish neonatal units (0% to 32.4% of the infants).

Patients and Setting:

The fecal Enterobacter species carriage rates among 953 infants in the 22 special-care neonatal units were correlated with variables related to the ward (size, crowding, staffing, work load, antibiotic usage, level of care, hygienic precautions), and the hospital (temperature of water supplied, geographical location).

Results:

The average Enterobacter species carriage rate was highest at seven days of age (17% of the infants) and then declined to 3%. Only location of the hospital in an area with warmer climate according to horticultural zone showed an association with Enterobacter species carriage in multivariate analysis (P= 0.005).

Conclusion:

Although Enterobacter species mainly cause nosocomially acquired infections, the occurrence of the organism in special-care neonatal units seemed to be determined more by extrahospital than by intrahospital factors.

Type
Brief Report
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993 

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References

1. John, JF, Sharbaugh, RJ, Bannister, ER. Enterobacter cloacae: bacteremia. epidemiology and antibiotic resistance. Rev Infect Dis 1982;4:1328.10.1093/clinids/4.1.13CrossRefGoogle ScholarPubMed
2. Gaston, MA. Enterobacter cloacae: an emerging nosocomial pathogen. J Hosp Infect 1988;11:197208.CrossRefGoogle Scholar
3. Centers for Disease Control. National nosocomial infection surveillance. In: CDC Surveillance Summaries, 33 (no. 355). Atlanta, GA: Centers for Disease Control and Prevention, 1984:17552955.Google Scholar
4. Tullus, K, Olsson-Liljequist, B, Lundström, G, Burman, LG. Antibiotic susceptibility of 629 bacterial blood and CSF isolates from Swedish infants and the therapeutic implications. Acta ftiediatr Scand 1991;80:205212.CrossRefGoogle ScholarPubMed
5. Gallagher, PG. Enterobacter bacteremia in pediatric patients. Rev Infect Dis 1990;12:808812.CrossRefGoogle ScholarPubMed
6. Flynn, DM, Weinstein, RA, Kabins, SA. Infections with gram-negative bacilli in a cardiac surgery intensive care unit: the relative role of enterobacter. J Hosp Infect 1988;11(suppl A):367373.CrossRefGoogle Scholar
7. Kühn, I, Tullus, K, Burman, LG. The use of the PhP-KE biochemical fingerprinting system in epidemiological studies of faecal Enterobacter cloacae strains from infants in Swedish neonatal wards. Epidemiol Infect 1991;107:311319.10.1017/S0950268800048950CrossRefGoogle ScholarPubMed
8. Tullus, K, Fryklund, B, Berglund, B, Källenius, G, Burman, LG. Influence of age on fecal carriage of P-fimbriated E coli and other gram-negative bacteria in hospitalized neonates. J Hosp Infect 1988;11:349356.10.1016/0195-6701(88)90088-6CrossRefGoogle ScholarPubMed
9. Fryklund, B, Tullus, K, Burman, LG. Relation between nursing procedures and other local characteristics and transmission of enteric bacteria in neonatal wards . J Hosp Infect. 1993;23:199210.10.1016/0195-6701(93)90025-UCrossRefGoogle ScholarPubMed
10. Tullus, K, Berglund, B, Fryklund, B, Kühn, I, Burman, LG. Epidemiology of faecal strains of enterobacteriaceae in 22 neonatal wards and influence of antibiotic policy. I Clin Microbiol 1988;26:11661170.CrossRefGoogle ScholarPubMed
11. Swedish Pomological Association Handbook. Stockholm, 1961:5859 (In Swedish).Google Scholar
12. Highsmith, AK, Emori, TG, Aguero, SM, Favero, MS, Hughes, JM. Heterotrophic bacteria isolated from hospital water systems. In: Proc Int Symp On Water-Related Health Issues. Atlanta, GA: American Water Resources Association, 1986:181187.Google Scholar
13. Retaillian, HF, Hightower, AW, Dixon, RE, Allen, JR. Acinetobacter: a nosocomial pathogen with an unusual seasonal pattern. J Infect Dis 1979;139:371375.CrossRefGoogle Scholar
14. Centers for Disease Control. MMWR 1983;32:1SS15SS.Google Scholar