Skip to main content Accessibility help
×
Home
Hostname: page-component-cf9d5c678-7bjf6 Total loading time: 0.449 Render date: 2021-07-30T05:47:35.416Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Klebsiella pneumoniae Bloodstream Infections Among Neonates in a High-Risk Nursery in Cali, Colombia

Published online by Cambridge University Press:  02 January 2015

Chesley Richards
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Juan Alonso-Echanove
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Yolanda Caicedo
Affiliation:
Hospital Universitario Del Valle, Cali, Colombia
William R. Jarvis
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia

Abstract

Objectives:

To determine the cause of an outbreak of Klebsiella pneumoniae bloodstream infections (BSIs) among neonates in a high-risk nursery and to institute control measures.

Design:

During the on-site investigation, a cohort study to identify risk factors for K. pneumoniae BSI, a point-prevalence study to assess K. pneumoniae colonization, a maternal cohort study to determine maternal K. pneumoniae colonization, and an observational study to evaluate healthcare worker (HCW) compliance with infection control practices were conducted.

Patients And Setting:

Neonates in a 40-bed high-risk nursery in a 700-bed university hospital in Cali, Colombia.

Intervention:

Cohorting of neonates colonized with K. pneumoniae.

Results:

The overall K. pneumoniae BSI attack rate was 10 of 105 (9.5%). In the retrospective cohort study, the number of blood transfusions (OR, 3.1 per transfusion; P = .02; CI95,1.4–9.7) and intravenous injections (OR, 1.2 per injection; P = .04; CI95, 1.0–1.5) were independently associated with K. pneumoniae BSI. The overall prevalence of K. pneumoniae colonization was 61% among neonates and 7% among mothers. During the HCW assessment, suboptimal intravenous therapy practices were observed. A cohorting intervention resulted in a significant reduction in K. pneumoniae colonization (12% vs 61%; RR, 0.19; P < .001). During the intervention period, no K. pneumoniae BSIs occurred.

Conclusions:

This investigation suggested that the outbreak probably occurred due to widespread colonization and suboptimal infection control and intravenous therapy practices. Cohorting successfully reduced the overall prevalence of K. pneumoniae colonization and, along with improved infection control practices, probably prevented K. pneumoniae BSIs.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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.Podschun, R, Ullmann, U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev 1998;11:589603.Google ScholarPubMed
2.Hariharan, R, Weinstein, RA. Enterobacteriaceae. In: Mayhall, G, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996.Google Scholar
3.Gaynes, RP, Edwards, JR, Jarvis, WR, et al. Nosocomial infections in neonates in high-risk nurseries in the United States. Pediatrics 1996;98:357361.Google Scholar
4.Al-Rabea, AA, Burwen, DR, Eldeen, MAF, Fontaine, RE, Tenover, F, Jarvis, WR. Klebsiella pneumoniae bloodstream infections in neonates in a hospital in the kingdom of Saudi Arabia. Infect Control Hosp Epidemiol 1998;19:674679.CrossRefGoogle Scholar
5.Hart, CA. Mebsiellae and neonates. J Hosp Infect 1993;23:8386.CrossRefGoogle Scholar
6.Pengsaa, K, Lumbiganon, P, Taksaphan, S, et al. Risk factors for neonatal Klebsiella septicemia in Srinagarind Hospital. Southeast Asian J Trap Med Public Health 1996;27:102106.Google ScholarPubMed
7.Moore, D. Nosocomial infections in newborn nurseries and neonatal intensive care units. In: Mayhall, G, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996.Google Scholar
8.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.CrossRefGoogle Scholar
9.Selden, R, Lee, S, Wang, W, Bennett, JV, Eickhoff, T. Nosocomial Klebsiella infections: intestinal colonization as a reservoir. Ann Intern Med 1971;74:657664.CrossRefGoogle Scholar
10.Jarvis, WR. The epidemiology of colonization. Infect Control Hosp Epidemiol 1996;17:4752.CrossRefGoogle Scholar
11.Centers for Disease Control and Prevention. Guideline for prevention of intravascular device-related infections. Am J Infect Control 1996;24:262293.CrossRefGoogle Scholar
12.Manning, ML, Archibald, LK, Bell, LM, Banerjee, SN, Jarvis, WR. Serratia marcescens transmission in a pediatric intensive care unit: a multifactorial occurrence. Am J Infect Control 2001;29:115119.CrossRefGoogle Scholar
13.Archibald, LK, Manning, ML, Bell, LM, Banerjee, SN, Jarvis, WR. Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric intensive care unit. Pediatr Infect Dis J 1997;16:10451048.CrossRefGoogle Scholar
17
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Klebsiella pneumoniae Bloodstream Infections Among Neonates in a High-Risk Nursery in Cali, Colombia
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Klebsiella pneumoniae Bloodstream Infections Among Neonates in a High-Risk Nursery in Cali, Colombia
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Klebsiella pneumoniae Bloodstream Infections Among Neonates in a High-Risk Nursery in Cali, Colombia
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *