Two outbreaks of ESBL‐producing <i><scp>K</scp>lebsiella pneumoniae</i> in a neonatal intensive care unit

Sümer, Şua; Dagi, Hatice Turk; Fındık, Duygu; Arslan, Uğur; Demir, Nazlım Aktuğ; Ural, Onur; Tuncer, İnci

doi:10.1111/ped.12234

Cited by 14 publications

(12 citation statements)

References 25 publications

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“…pneumoniae, in particular ESBL-producing strains, is an important cause of nosocomial infections in humans worldwide (Podschun and Ullmann, 1998;Marra et al, 2006;EFSA, 2011;Sumer et al, 2014). For Indonesia, an increase of ESBLs within clinical isolates of K. pneumoniae has been reported in recent years (Herwana et al, 2008, Kuntaman et al, 2011Parwati et al, 2012;Saharman and Lestari, 2013).…”

Section: Introductionmentioning

confidence: 95%

Extended-Spectrum β-Lactamase (ESBL)–ProducingKlebsiella pneumoniaein Bulk Tank Milk from Dairy Farms in Indonesia

Sudarwanto

Akineden

Odenthal

et al. 2015

Foodborne Pathogens and Disease

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Bulk tank milk from 80 dairy farms located in the West Java Region of Indonesia was analyzed for the presence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Isolates from seven dairy farms were ESBL positive, and all were identified as Klebsiella pneumoniae. The isolates showed ESBL-characteristic antibiotic resistance patterns. Further analysis revealed that all K. pneumoniae isolates harbored the blaSHV gene, and two isolates were additionally positive for the blaTEM-1 and blaCTX-M-15 genes. Isolates from different farms were clonally diverse according to macrorestriction analysis. The results indicate that the relatively high frequency of ESBL-producing K. pneumoniae in bulk tank milk implies the risk that milk is both a source of local exposure and a vector contributing to the supraregional spread of antibiotic-resistant bacteria by trade.

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Section: Introductionmentioning

confidence: 95%

Extended-Spectrum β-Lactamase (ESBL)–ProducingKlebsiella pneumoniaein Bulk Tank Milk from Dairy Farms in Indonesia

Sudarwanto

Akineden

Odenthal

et al. 2015

Foodborne Pathogens and Disease

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“…The eligible studies were undertaken in 30 NICUs in 15 locations. Nineteen (63%) came from high income countries, 3 – 21 four (13%) from upper-middle income countries, 22 – 25 six (20%) from lower-middle income countries 26 – 31 and one (3%) from a low income country. 32 Six studies reported Methicillin-resistant Staphylococcus aureus (MRSA).…”

Section: Resultsmentioning

confidence: 99%

“…The source of the outbreak was identified in 17 studies: a patient transferred in from another hospital (6/17) 6 , 7 , 23 – 25 , 29 ; healthcare worker (4/17) 13 , 19 , 28 , 30 ; contaminated ventilator equipment (5/17) 9 , 16 , 21 , 31 and mothers colonized on surface swabs (2/17). 4 , 26 …”

Section: Resultsmentioning

confidence: 99%

“…Point-prevalence rectal swabs and/or environmental swabs were undertaken in 15/20 studies to assess the recurrence of Gram-negative pathogens. 4 , 6 – 9 , 13 , 16 , 18 , 20 , 21 , 23 – 25 , 28 , 29 Four studies reported subsequent new outbreaks despite changes to guidelines and education. 11 , 20 , 21 , 27 The remaining studies did not identify any further outbreaks, although the follow up period varied from 1–50 months.…”

Section: Resultsmentioning

confidence: 99%

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Lack of evidence for the efficacy of enhanced surveillance compared to other specific interventions to control neonatal healthcare-associated infection outbreaks

Birt¹,

Doare²,

Kortsalioudaki³

et al. 2016

Trans R Soc Trop Med Hyg

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BackgroundDespite current prevention efforts, outbreaks of healthcare-associated infections in neonatal units remain high globally, with a considerable burden of mortality and morbidity.MethodsWe searched Medline, Cochrane Library and Outbreak database to identify studies of neonatal healthcare-associated outbreaks between 2005 and 2015 that described interventions to control outbreaks. All studies were evaluated using the ORION guidance.ResultsThirty studies were identified including 17 102 infants of whom 664 (3.9%) became infected. No single intervention was identified that reduced duration or mortality. Studies that introduced multiple interventions had significantly reduced case fatality ratio and outbreak duration compared to those that used basic surveillance only. Low and low-middle income countries reported the fewest interventions to control outbreaks and these studies were also associated with higher mortality than that found in middle and high income countries.ConclusionsSystematic reporting and formal evaluation of interventions used to reduce healthcare-associated neonatal infection outbreaks is key to identifying containment strategies worldwide.

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“…Until now, most of the data have not allowed us to identify the modes of acquisition and to consider the best control policies. Indeed, the most frequent published reports regarding the risk factors of infection or colonization by ESBL-PE bacteria were from NICUs 9 , 15 – 19 , and little is known about factors associated with spreading in the community. Most reports often describe single-unit outbreaks 16 , 17 , 20 and health care-related risk factors.…”

Section: How To Control the Risk Of Transmissionmentioning

confidence: 99%

The potential role of microbiota for controlling the spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) in neonatal population

et al. 2017

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The spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) in the hospital and also the community is worrisome. Neonates particularly are exposed to the risk of ESBL-PE acquisition and, owing to the immaturity of their immune system, to a higher secondary risk of ESBL-PE-related infection. Reducing the risk of acquisition in the hospital is usually based on a bundle of measures, including screening policies at admission, improving hand hygiene compliance, and decreasing antibiotic consumption. However, recent scientific data suggest new prevention opportunities based on microbiota modifications.

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Two outbreaks of ESBL‐producing Klebsiella pneumoniae in a neonatal intensive care unit

Abstract: The deficiencies in the infection control measures in an NICU may transform into an epidemic rapidly. Therefore, periodic training, observation, and monitoring of compliance are important.

Cited by 14 publications

References 25 publications

Extended-Spectrum β-Lactamase (ESBL)–ProducingKlebsiella pneumoniaein Bulk Tank Milk from Dairy Farms in Indonesia

Extended-Spectrum β-Lactamase (ESBL)–ProducingKlebsiella pneumoniaein Bulk Tank Milk from Dairy Farms in Indonesia

Lack of evidence for the efficacy of enhanced surveillance compared to other specific interventions to control neonatal healthcare-associated infection outbreaks

The potential role of microbiota for controlling the spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) in neonatal population

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