Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-28T18:59:28.597Z Has data issue: false hasContentIssue false

Outbreak of Nosocomial Sepsis and Pneumonia in a Newborn Intensive Care Unit by Multiresistant Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae High Impact on Mortality

Published online by Cambridge University Press:  02 January 2015

Gerardo Martínez-Aguilar
Affiliation:
Unidad de Investigation Medica en Epidemiologia Clinica, Hospital Regional de Zona No. 1, Instituto Mexicano del Seguro Social, Durango
Celia M. Alpuche-Aranda*
Affiliation:
Departamento de Medicina Experimental, Facultad de Medicina, Universidad National Autonoma de Mexico-Hospital General de Mexico, Hospital General de Durango, SSA, Durango, Mexico
Carmen Anaya
Affiliation:
Unidad de Investigation Medica en Epidemiologia Clinica, Hospital Regional de Zona No. 1, Instituto Mexicano del Seguro Social, Durango
Dolores Alcantar-Curiel
Affiliation:
Departamento de Medicina Experimental, Facultad de Medicina, Universidad National Autonoma de Mexico-Hospital General de Mexico, Hospital General de Durango, SSA, Durango, Mexico
Catalina Gayosso
Affiliation:
Departamento de Medicina Experimental, Facultad de Medicina, Universidad National Autonoma de Mexico-Hospital General de Mexico, Hospital General de Durango, SSA, Durango, Mexico
Carlos Daza
Affiliation:
Departamento de Medicina Experimental, Facultad de Medicina, Universidad National Autonoma de Mexico-Hospital General de Mexico, Hospital General de Durango, SSA, Durango, Mexico
Cesar Mijares
Affiliation:
Laboratorio de Microbiologia, Hospital General de Durango, SSA, Durango, Mexico
Juan C. Tinoco
Affiliation:
Laboratorio de Microbiologia, Hospital General de Durango, SSA, Durango, Mexico
Jose I. Santos
Affiliation:
Departamento de Medicina Experimental, Facultad de Medicina, Universidad National Autonoma de Mexico-Hospital General de Mexico, Hospital General de Durango, SSA, Durango, Mexico
*
Medicina Experimental, UNAM-Hospital General de Mexico, Dr. Balmis 148, 06726, Mexico DE

Abstract

We describe a case-control study of a small outbreak of nosocomial sepsis and pneumonia with high mortality due to clonal dissemination of a multiresistant Klebsiella pneumoniae in the neonatal intensive care unit of a Mexican institution. Our study helped to change nosocomial infection control policy in this hospital.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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.Waggoner, LA, Donowitz, LG. Infection in newborns. In: Wenzel, RP. Prevention and Control of Nosocomial Infections. 3rd ed. Baltimore, MD: Williams & Wilkins, 1997:10191038.Google Scholar
2.Tenover, FC, Hughes, JM. The challenge of emerging infectious diseases: development and spread of multiply-resistant bacterial pathogens. JAMA 1996;275:30003004.Google Scholar
3.Toltzis, P, Blumer, JL. Nosocomial acquisition and transmission of antibiotic-resistant gram-negative organisms in the pediatric intensive care unit. Pediatr Infect Dis J 2001;20:612618.Google Scholar
4.Flidel-Rimon, O, Leibovitz, E, Juster-Reicher, A, Amitay, M, Miskin, A, Barak, Y, et al.An outbreak of antibiotic multiresistant Klebsiella at the neonatal intensive care unit, Kaplan Hospital, Rehovot Israel, November 1991 to April 1992. Am J Perinatol 1996;13:99102.Google Scholar
5.Jacoby, GA. Extended-spectrum (β-lactamases and other enzymes provided resistance to oxyimino-β-lactams. Infect Dis Clin North Am 1997;11:875887.Google Scholar
6.Avila-Figueroa, C, Cashat-Cruz, M, Aranda-Patron, E, Leon, AR, Justiniani, N, Perez-Ricardez, L, et al.Prevalence of nosocomial infections in children: survey of 21 hospitals in Mexico [in Spanish]. Salud Publico Mex 1999;41(suppl):S18S25.Google Scholar
7.Miranda, G, Rely, C, Solorzano, F, Leanos, B, Coria, R, Evans, J. Use of pulsed-field gel electrophoresis typing to study an outbreak of infection due to Serratia marcescens in a neonatal intensive care unit. J Clin Microbiol 1996;34:31383141.Google Scholar
8.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. In: Olmsted, RN, ed. APIC Infection Control and Applied Epidemiology: Principles and Practices. St. Louis, MO: Mosby; 1996:A1A20.Google Scholar
9.National Committee for Clinical Laboratory Standards 2000. Methods for Dilution Antimicrobial Susceptibility Test for Bacteria That Grow Aerobically. 5th ed. Wayne, PA: National Committee for Clinical Laboratory Standards; 2000.Google Scholar
10.Goering, R. Molecular epidemiology of nosocomial infection: analysis of chromosomal restriction fragment patterns by pulsed-field gel electrophoresis. Infect Control Hosp Epidemiol 1993;14:595600.Google Scholar
11.Mathew, M, Harris, AM, Marshall, MJ, Ross, GW. The use of analytical iso-electrical focusing for detection and identification of p-lactamases. J Gen Microbiol 1975;88:169178.Google Scholar
12.Haley, W, Bregman, DA. Role of understaffing and overcrowding in recurrent outbreaks of staphylococcal infections in a neonatal special-care unit. J Infect Dis 1982;145:875885.Google Scholar
13.Silva, J, Aguilar, G, Estrada, MA, Ramos-Garza, V, Lemus-Lara, R, Ledezma, L. TLA-1: a new plasmid mediated extended spectrum β-lactamase from Escherichia coli. Antimicrob Agent Chemother 2000;44:9971003.CrossRefGoogle ScholarPubMed