Tags

Type your tag names separated by a space and hit enter

Continuous surveillance to reduce extended-spectrum β-lactamase Klebsiella pneumoniae colonization in the neonatal intensive care unit.
Neonatology. 2013; 103(2):155-60.N

Abstract

BACKGROUND

Clinical illness caused by resistant bacteria usually represents a wider problem of asymptomatic colonization. Active surveillance with appropriate institution of isolation precautions represents a potential mechanism to control colonization and reduce infection. The neonatal intensive care unit (NICU) is an environment particularly appropriate for such interventions. Neonates are rarely colonized by resistant bacteria on admission and staff enthusiasm for infection control is high.

OBJECTIVE

To reduce extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) acquisition amongst neonates through a continuous active surveillance intervention.

METHODS

Fecal ESBL-KP cultures were performed weekly on all neonates over 4 years. Neonates with positive cultures were managed with contact precautions by dedicated nurses separately from other neonates. ESBL-KP acquisition amongst neonates staying >7 days was compared for the consecutive years. A subset of ESBL-KP isolates was typed with pulsed-field gel electrophoresis (PFGE).

RESULTS

Surveillance cultures were obtained from 1,482/1,763 (84%) neonates over 4 years. ESBL-KP acquisition decreased continuously from 94/397 (24%) neonates in 2006 to 33/304 (11%) in 2009 (p < 0.001, hazard ratio 0.75, 95% confidence interval 0.66-0.85, p < 0.001 for comparison of years). Hospital-wide ESBL-KP acquisition did not decrease outside the NICU. PFGE identified identical ESBL-KP strains from multiple neonates on six occasions and different strains from single neonates on seven occasions.

CONCLUSIONS

ESBL-KP is probably both imported into and spread within the NICU. Continuous long-term surveillance with cohorting was associated with a decrease in ESBL-KP acquisition within the NICU. This low-risk intervention should be considered as a means to decrease neonatal acquisition of resistant bacteria.

Authors+Show Affiliations

Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

23235260

Citation

Benenson, Shmuel, et al. "Continuous Surveillance to Reduce Extended-spectrum Β-lactamase Klebsiella Pneumoniae Colonization in the Neonatal Intensive Care Unit." Neonatology, vol. 103, no. 2, 2013, pp. 155-60.
Benenson S, Levin PD, Block C, et al. Continuous surveillance to reduce extended-spectrum β-lactamase Klebsiella pneumoniae colonization in the neonatal intensive care unit. Neonatology. 2013;103(2):155-60.
Benenson, S., Levin, P. D., Block, C., Adler, A., Ergaz, Z., Peleg, O., Minster, N., Gross, I., Schaffer, K., Moses, A. E., & Cohen, M. J. (2013). Continuous surveillance to reduce extended-spectrum β-lactamase Klebsiella pneumoniae colonization in the neonatal intensive care unit. Neonatology, 103(2), 155-60. https://doi.org/10.1159/000343150
Benenson S, et al. Continuous Surveillance to Reduce Extended-spectrum Β-lactamase Klebsiella Pneumoniae Colonization in the Neonatal Intensive Care Unit. Neonatology. 2013;103(2):155-60. PubMed PMID: 23235260.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Continuous surveillance to reduce extended-spectrum β-lactamase Klebsiella pneumoniae colonization in the neonatal intensive care unit. AU - Benenson,Shmuel, AU - Levin,Phillip D, AU - Block,Colin, AU - Adler,Amos, AU - Ergaz,Zivanit, AU - Peleg,Ofra, AU - Minster,Naomi, AU - Gross,Ilana, AU - Schaffer,Keren, AU - Moses,Allon E, AU - Cohen,Matan J, Y1 - 2012/12/11/ PY - 2012/05/10/received PY - 2012/09/03/accepted PY - 2012/12/14/entrez PY - 2012/12/14/pubmed PY - 2013/7/17/medline SP - 155 EP - 60 JF - Neonatology JO - Neonatology VL - 103 IS - 2 N2 - BACKGROUND: Clinical illness caused by resistant bacteria usually represents a wider problem of asymptomatic colonization. Active surveillance with appropriate institution of isolation precautions represents a potential mechanism to control colonization and reduce infection. The neonatal intensive care unit (NICU) is an environment particularly appropriate for such interventions. Neonates are rarely colonized by resistant bacteria on admission and staff enthusiasm for infection control is high. OBJECTIVE: To reduce extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) acquisition amongst neonates through a continuous active surveillance intervention. METHODS: Fecal ESBL-KP cultures were performed weekly on all neonates over 4 years. Neonates with positive cultures were managed with contact precautions by dedicated nurses separately from other neonates. ESBL-KP acquisition amongst neonates staying >7 days was compared for the consecutive years. A subset of ESBL-KP isolates was typed with pulsed-field gel electrophoresis (PFGE). RESULTS: Surveillance cultures were obtained from 1,482/1,763 (84%) neonates over 4 years. ESBL-KP acquisition decreased continuously from 94/397 (24%) neonates in 2006 to 33/304 (11%) in 2009 (p < 0.001, hazard ratio 0.75, 95% confidence interval 0.66-0.85, p < 0.001 for comparison of years). Hospital-wide ESBL-KP acquisition did not decrease outside the NICU. PFGE identified identical ESBL-KP strains from multiple neonates on six occasions and different strains from single neonates on seven occasions. CONCLUSIONS: ESBL-KP is probably both imported into and spread within the NICU. Continuous long-term surveillance with cohorting was associated with a decrease in ESBL-KP acquisition within the NICU. This low-risk intervention should be considered as a means to decrease neonatal acquisition of resistant bacteria. SN - 1661-7819 UR - https://www.unboundmedicine.com/medline/citation/23235260/Continuous_surveillance_to_reduce_extended_spectrum_β_lactamase_Klebsiella_pneumoniae_colonization_in_the_neonatal_intensive_care_unit_ L2 - https://www.karger.com?DOI=10.1159/000343150 DB - PRIME DP - Unbound Medicine ER -