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Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails.
Infect Control Hosp Epidemiol. 2004 Mar; 25(3):210-5.IC

Abstract

BACKGROUND

From April to June 2001, an outbreak of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae infections was investigated in our neonatal intensive care unit.

METHODS

Cultures of the gastrointestinal tracts of patients, the hands of healthcare workers (HCWs), and the environment were performed to detect potential reservoirs for ESBL-producing K. pneumoniae. Strains of K. pneumoniae were typed by pulsed-field gel electrophoresis using XbaI. A case-control study was performed to determine risk factors for acquisition of the outbreak clone (clone A); cases were infants infected or colonized with clone A and controls (3 per case) were infants with negative surveillance cultures.

RESULTS

During the study period, 19 case-infants, of whom 13 were detected by surveillance cultures, harbored clone A. The overall attack rate for the outbreak strain was 45%; 9 of 19 infants presented with invasive disease (n = 6) or developed invasive disease (n = 3) after colonization was detected. Clone A was found on the hands of 2 HCWs, 1 of whom wore artificial nails, and on the designated stethoscope of a case-infant. Multiple logistic regression analysis revealed that length of stay per day (odds ratio [OR], 1.05; 95% confidence interval [CI95], 1.02 to 1.09) and exposure to the HCW wearing artificial fingernails (OR, 7.87; CI95, 1.75 to 35.36) were associated with infection or colonization with clone A.

CONCLUSION

Short, well-groomed, natural nails should be mandatory for HCWs with direct patient contact

Authors+Show Affiliations

Department of Pediatrics, Columbia University, New York-Presbyterian Hospital, New York, New York 10032, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15061412

Citation

Gupta, Archana, et al. "Outbreak of Extended-spectrum Beta-lactamase-producing Klebsiella Pneumoniae in a Neonatal Intensive Care Unit Linked to Artificial Nails." Infection Control and Hospital Epidemiology, vol. 25, no. 3, 2004, pp. 210-5.
Gupta A, Della-Latta P, Todd B, et al. Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. Infect Control Hosp Epidemiol. 2004;25(3):210-5.
Gupta, A., Della-Latta, P., Todd, B., San Gabriel, P., Haas, J., Wu, F., Rubenstein, D., & Saiman, L. (2004). Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. Infection Control and Hospital Epidemiology, 25(3), 210-5.
Gupta A, et al. Outbreak of Extended-spectrum Beta-lactamase-producing Klebsiella Pneumoniae in a Neonatal Intensive Care Unit Linked to Artificial Nails. Infect Control Hosp Epidemiol. 2004;25(3):210-5. PubMed PMID: 15061412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. AU - Gupta,Archana, AU - Della-Latta,Phyllis, AU - Todd,Betsy, AU - San Gabriel,Pablo, AU - Haas,Janet, AU - Wu,Fann, AU - Rubenstein,David, AU - Saiman,Lisa, PY - 2004/4/6/pubmed PY - 2004/5/14/medline PY - 2004/4/6/entrez SP - 210 EP - 5 JF - Infection control and hospital epidemiology JO - Infect Control Hosp Epidemiol VL - 25 IS - 3 N2 - BACKGROUND: From April to June 2001, an outbreak of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae infections was investigated in our neonatal intensive care unit. METHODS: Cultures of the gastrointestinal tracts of patients, the hands of healthcare workers (HCWs), and the environment were performed to detect potential reservoirs for ESBL-producing K. pneumoniae. Strains of K. pneumoniae were typed by pulsed-field gel electrophoresis using XbaI. A case-control study was performed to determine risk factors for acquisition of the outbreak clone (clone A); cases were infants infected or colonized with clone A and controls (3 per case) were infants with negative surveillance cultures. RESULTS: During the study period, 19 case-infants, of whom 13 were detected by surveillance cultures, harbored clone A. The overall attack rate for the outbreak strain was 45%; 9 of 19 infants presented with invasive disease (n = 6) or developed invasive disease (n = 3) after colonization was detected. Clone A was found on the hands of 2 HCWs, 1 of whom wore artificial nails, and on the designated stethoscope of a case-infant. Multiple logistic regression analysis revealed that length of stay per day (odds ratio [OR], 1.05; 95% confidence interval [CI95], 1.02 to 1.09) and exposure to the HCW wearing artificial fingernails (OR, 7.87; CI95, 1.75 to 35.36) were associated with infection or colonization with clone A. CONCLUSION: Short, well-groomed, natural nails should be mandatory for HCWs with direct patient contact SN - 0899-823X UR - https://www.unboundmedicine.com/medline/citation/15061412/Outbreak_of_extended_spectrum_beta_lactamase_producing_Klebsiella_pneumoniae_in_a_neonatal_intensive_care_unit_linked_to_artificial_nails_ L2 - https://www.cambridge.org/core/product/identifier/ICHE7676/type/journal_article DB - PRIME DP - Unbound Medicine ER -