Korean J Nosocomial Infect Control.  2013 Jun;18(1):26-32. 10.14192/kjnic.2013.18.1.26.

Successful Control of Extended-spectrum Beta-lactamase-producing Klebsiella pneumoniae Outbreak in a Neonatal Intensive Care Unit

• Kim MJ
• Chung KS
• Sohn KM

• KMID: 1428638
• DOI: http://doi.org/10.14192/kjnic.2013.18.1.26

Abstract

BACKGROUND
Extended-spectrum beta-lactamase-producing (ESBL) Klebsiella pneumoniae is an important cause of nosocomial infections in neonatal intensive care units (NICUs). This study aimed to reduce ESBL-producing K. pneumoniae in the NICU by using infection control measures.
METHODS
We performed prospective surveillance cultures, monitoring, and education for infection control in the NICU between May and August 2011. Specimens were collected from all infants and the environment including stethoscopes, thermometers, ventilators, incubators, etc. The anterior nares and hands of healthcare workers were also screened. We inspected infection control practices and provided feedback. The level of infection control awareness was measured using a questionnaire.
RESULTS
The level of awareness and performance of hand washing increased significantly after intervention (both P<0.001). The environmental management of healthcare providers also improved significantly (P=0.001). The yield of ESBL-producing K. pneumoniae from clinical specimens decreased gradually throughout the study period (30.4% in May to 12.6% in August). Central catheter-related K. pneumoniae bacteremia decreased from 1.3/1000 to 0/1000 catheter-days.
CONCLUSION
Infection control measures including education, monitoring, and surveillance can lower the incidence of ESBL-producing K. pneumoniae in the NICU.

Keyword

Beta-Lactamases; Infant; Intensive care units; Klebsiella pneumoniae; Newborn

MeSH Terms

Bacteremia
beta-Lactamases
Cross Infection
Delivery of Health Care
Hand
Hand Disinfection
Health Personnel
Humans
Incidence
Incubators
Infant
Infant, Newborn
Infection Control
Intensive Care Units
Intensive Care Units, Neonatal
Intensive Care, Neonatal
Klebsiella
Klebsiella pneumoniae
Pneumonia
Prospective Studies
Stethoscopes
Thermometers
Ventilators, Mechanical
beta-Lactamases

Figure

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  Fig. 1. Outbreak of ESBL-producing K. pneumonia in the neonatal intensive care unit.

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  Fig. 2. The timeline of this study.

Reference

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