Epidemiological Analysis of Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> Outbreak in a Neonatal Clinic in Poland

• Main Authors: Agata Pruss (Author), Paweł Kwiatkowski (Author), Helena Masiuk (Author), Iwona Bilska (Author), Stefania Giedrys-Kalemba (Author), Barbara Dołęgowska (Author)
• Format: Book
• Published: MDPI AG, 2022-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<i>Klebsiella pneumoniae</i> is one of the most common etiological agents isolated from epidemic outbreaks in neonatal wards. We describe how an extended-spectrum β-lactamase-producing <i>K. pneumoniae</i> (ESBL-KP) outbreak in a neonatal ward was extinguished. During the outbreak, which lasted over two months, 26 neonates were tested for <i>K. pneumoniae</i>, and 42 environmental swabs were taken. Drug susceptibility was determined for the isolated strains, and their virulence and phylogenetic similarity were checked. ESBL-KP colonization was confirmed in 18 neonates, and six were also confirmed to be infected. All strains isolated from patients represented one clonal type, <i>K. pneumoniae.</i> One strain isolated from an environmental source was determined to be a unique pulsed-field gel electrophoresis pattern. Gestational age and Apgar score were assessed as statistically significant for neonates with ESBL-KP infection. The epidemiological measures taken have been successful, and no further cases appeared. Immediate tightening of hospital hygiene rules, screening of all hospitalized neonates, and cohorting ESBL-KP-positive patients proved effective in controlling and ending the outbreak. The lack of ESBL-KP in the environment suggests that the outbreak was transmitted by colonized hospital staff. This theory could be confirmed by introducing mandatory screening for medical personnel.

Item Description

10.3390/antibiotics12010050
2079-6382