Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in a neonatal intensive care unit
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Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in a neonatal intensive care unit Rong Lin, Bo Wu, Xin-Fen Xu, Xin-Chang Liu, Hong Ye, Guang-Yong Ye Hangzhou, China
Brief report
Background: A molecular epidemiological survey was conducted on an extended-spectrum betalactamase-producing Klebsiella pneumoniae (ESBLKp) infection in our neonatal intensive care unit (NICU) from February to June 2008. Methods: Cultures of clinical samples from neonates in the NICU, the hands of healthcare workers and the environment of the NICU were subjected to ESBLKp isolation. Pulsed-field gel electrophoresis was performed to determine Klebsiella pneumoniae strains (type A-D). Results: In 1439 neonates, 38 (2.6%) had infections and 65 (4.5%) had colonizations with ESBLKp. Microbiological sampling of the NICU environment yielded 33 (14.9%) ESBLKp isolates from 222 samples. Clone A was found in 88.2% of the infected neonates, 66.7% of the colonized neonates, 69.7% of the environmental samples, and the hands of a healthcare worker. Conclusions: The detection rate of ESBLKp is high in environmental samples, especially those from frequently touched surfaces. Since ESBLKp was identified on the hands of a healthcare worker in the present study, hand and environmental hygiene is mandatory for infection control in neonatal intensive care units. World J Pediatr 2012;8(3):268-271 Key words: infection; Klebsiella Pneumoniae; molecular epidemiology; neonatal intensive care unit
Author Affiliations: Department of Infection Control, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China (Lin R, Wu B, Xu XF, Liu XC, Ye H, Ye GY) Corresponding Author: Xin-Fen Xu, MD, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China (Tel: 86-057189991038; Fax: 86-0571-87061878; Email: [email protected]) doi:10.1007/s12519-012-0370-4 ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2012. All rights reserved.
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Introduction
K
lebsiella pneumoniae (K. pneumoniae) is an important cause of nosocomial infections in neonatal intensive care units (NICU).[1,2] During the past decade, infection outbreaks of extendedspectrum-beta-lactamase-producing K. pneumoniae (ESBLKp) have been frequently seen in pediatric hospitals and NICUs, although the therapeutic options are limited because of their resistance to multiantibiotics.[1-4] We investigated an outbreak of ESBLKp infection in our NICU from February 2008 to June 2008. In this article, we report a molecular investigation of this nosocomial outbreak and its epidemiologic characteristics.
Methods
Women's Hospital, Zhejiang University School of Medicine is a teaching hospital in Zhejiang Province, China, which has 28 654 births per year, of whom 3770 are admitted to the NICU. The NICU has three rooms which has a capacity of 30, 15 and 3 patients, respectively. It has 43 physicians and 29 nurses, with a patient to nurse ratio of 50:29. In February 2008, routine surveillance reveale
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