Study of an outbreak of Enterobacter cloacae sepsis in a neonatal intensive care unit: The application of epidemiologic chromosome profiling by pulsed-field gel electrophoresis

Liu, Shu-Chih; Leu, Hsieh-Shong; Yen, Muh–Yong; Lee, Ping–Ing; Chou, Ming-Chih

doi:10.1067/mic.2002.121426

Cited by 20 publications

(6 citation statements)

References 17 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Outbreaks of infections caused by gram-negative bacilli are well recognized [6,7]. There have been fewer recent attempts, however, to prospectively characterize the epidemiology of endemic health care-associated infections due to gram-negative bacteria in the absence of a recognized outbreak [8,9].…”

Section: We Sought To Characterize the Molecular Epidemiology Of Grammentioning

confidence: 99%

“…Although gram-positive cocci are the most common pathogens in NICU patients, morbidity and mortality rates are highest for sepsis caused by gramnegative pathogens and yeast [4]. Recent studies have indicated that the incidence of gram-negative bacterial infections in NICUs may be increasing [5].Outbreaks of infections caused by gram-negative bacilli are well recognized [6,7]. There have been fewer recent attempts, however, to prospectively characterize the epidemiology of endemic health care-associated infections due to gram-negative bacteria in the absence of a recognized outbreak [8,9].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Molecular Epidemiology of Gram-Negative Bacilli from Infected Neonates and Health Care Workers' Hands in Neonatal Intensive Care Units

Waters¹,

Larson²,

et al. 2004

Clinical Infectious Diseases

View full text Add to dashboard Cite

We sought to characterize the molecular epidemiology of gram-negative bacilli (GNB) causing infections in infants and associated with carriage on nurses' hands after hand hygiene was performed. From March 2001 to January 2003, GNB caused 192 (34%) of 562 hospital-acquired infections in the 2 participating neonatal intensive care units (NICUs) and were isolated from the hands of 45 (38%) of 119 nurses. Five species--Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Serratia marcescens and Enterobacter cloacae, all of which were typed by pulsed-field gel electrophoresis--caused 169 (88%) of 192 of GNB infections. Overall, 58% of infections were caused by unique strains not cultured from other infants or nurses, and 31% of infections were part of unrecognized molecular clusters. In contrast, only 9% of strains that caused infections were cultured from nurses' hands. These data suggest that practices in addition to hand hygiene are needed to prevent horizontal transmission of GNB in the NICU.

show abstract

Section: We Sought To Characterize the Molecular Epidemiology Of Grammentioning

confidence: 99%

mentioning

confidence: 99%

Molecular Epidemiology of Gram-Negative Bacilli from Infected Neonates and Health Care Workers' Hands in Neonatal Intensive Care Units

Waters¹,

Larson²,

et al. 2004

Clinical Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Nosocomial outbreaks of E. cloacae bloodstream infection in paediatric intensive care units (ICUs) have been reported. 2,3 Since the introduction of extended-spectrum cephalosporins, the prevalence of Gram-negative pathogens resistant to these antibiotics has been increasing. 4 Although antimicrobial resistance arises via several mechanisms, the most important is the production of enzymes that hydrolyse the b-lactam ring.…”

Section: Introductionmentioning

confidence: 99%

Nosocomial and community-acquired Enterobacter cloacae bloodstream infection: risk factors for and prevalence of SHV-12 in multiresistant isolates in a medical centre

Liu

Wang

Lee

et al. 2004

Journal of Hospital Infection

View full text Add to dashboard Cite

“…Problematic within the enteric bacilli are organisms that constitutively produce chromosomal beta-lactamases (class I, ampC beta-lactamases), including Enterobacter spp., Serratia spp., and some strains of Citrobacter spp. (17). Just as difficult to treat are enteric bacilli which contain newly evolving beta-lactamases, termed extended-spectrum beta-lactamases (ESBL), most often present in strains of Klebsiella spp.…”

mentioning

confidence: 99%

Population Pharmacokinetics of Cefepime in the Neonate

Capparelli

Hochwald

Rasmussen

et al. 2005

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Newborn infants cared for in neonatal intensive care units may develop nosocomial infections. Cefepime, a "fourth-generation" cephalosporin (i.e., with activity against virtually all of the chromosomal-beta-lactamaseproducing and many extended-spectrum-beta-lactamase-producing organisms), provides excellent activity against many gram-negative pathogens resistant to expanded-spectrum cephalosporins currently used to treat neonatal infections. The purpose of this study was to determine the pharmacokinetics of cefepime in this population to optimize dosing and minimize potential adverse events. Premature and term infants <4 months of age hospitalized in two neonatal intensive care units were studied. Limited pharmacokinetic (PK) sampling occurred following a dose of cefepime at 50 mg/kg of body weight infused over 30 min. Population pharmacokinetic parameters were determined using the program NONMEM. Fifty-five infants were enrolled. Their average (؎ standard deviation) gestational age at birth was 30.5 ؎ 5.3 weeks, and their average postnatal age at PK evaluation was 14.5 ؎ 14.7 days. In the final PK model, cefepime clearance (CL) was strongly associated with serum creatinine (SCr) (CL [ml/min/kg] ‫؍‬ 0.26 ؉ 0.59/SCr). The volume of distribution for infants with a postconceptional age of <30 weeks was larger than that for infants with a postconceptional age of >30 weeks (0.51 versus 0.39 liter/kg, respectively). The Bayesian analysis-predicted cefepime trough concentration at a dose of 50 mg/kg every 12 h for infants <14 days of age was 29.9 ؎ 16.6 g/ml. Cefepime, dosed at 30 mg/kg/dose every 12 h for infants less than 14 days of age, regardless of gestational age, should provide antibiotic exposure equivalent to or greater than 50 mg/kg every 8 h in older infants and children.

show abstract

Study of an outbreak of Enterobacter cloacae sepsis in a neonatal intensive care unit: The application of epidemiologic chromosome profiling by pulsed-field gel electrophoresis

Cited by 20 publications

References 17 publications

Molecular Epidemiology of Gram-Negative Bacilli from Infected Neonates and Health Care Workers' Hands in Neonatal Intensive Care Units

Molecular Epidemiology of Gram-Negative Bacilli from Infected Neonates and Health Care Workers' Hands in Neonatal Intensive Care Units

Nosocomial and community-acquired Enterobacter cloacae bloodstream infection: risk factors for and prevalence of SHV-12 in multiresistant isolates in a medical centre

Population Pharmacokinetics of Cefepime in the Neonate

Contact Info

Product

Resources

About