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VIM-Klebsiella oxytoca outbreak in a Neonatal Intensive Care Unit. This time it wasn't the drain.
J Prev Med Hyg. 2017 Dec; 58(4):E302-E307.JP

Abstract

Objective

We describe an outbreak of VIM-carbapenemase Klebsiella oxytoca (VIM-Kox) in a NICU.

Materials and methods

Prospective Epidemiological Surveillance:Systematically (weekly screening cultures) or on admission, if the patient had a history of previous colonization by VIM-Kox.Clinical cultures, done if infection was suspected.Other possible microorganism sources were investigated: their mothers (rectal microbiota), milk packages and preparation apparata in the lactodietary section, echocardiagram transductors, cribs, the sinks (faucets and drains), washing bowls, etc.Molecular typing was performed using the DiversiLab (bioMérieux) system on all VIM-Kox isolated from environment or patients (one by neonate).

Results

We identified 20 VIM-Kox cases, the most only presented colonization, but 4 showed infection. Three of the ten sinks (drains) in our NICU, were positive for VIM-Kox. Another four drains harbored P.aeruginosa, S. maltophilia and/or Enterobacter sp. Nevertheless the VIM-Kox bacteria in the sinks (drains) were not the same as those in the patients, who showed three different strains.

Conclusions

A VIM-Kox colonization or infection outbreak in a NICU is described. Rather than environment, not even drains, the source of the outbreak was other patients. The outbreak was relatively brief, as a result of the rapidness with which appropriate measures were taken and followed.

Authors+Show Affiliations

Department of Preventive Medicine and Public Health and Microbiology, School of Medicine, Autonomous University of Madrid, Spain.Microbiology Service, Universitary Hospital "La Paz", Madrid, Spain.Preventive Medicine Service, Universitary Hospital "La Paz", Madrid, Spain.Preventive Medicine Service, Universitary Hospital "La Paz", Madrid, Spain.Microbiology Service, Universitary Hospital "La Paz", Madrid, Spain.Neonatology Service, Children Hospital.Universitary Hospital "La Paz", Madrid, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29707661

Citation

Herruzo, R, et al. "VIM-Klebsiella Oxytoca Outbreak in a Neonatal Intensive Care Unit. This Time It Wasn't the Drain." Journal of Preventive Medicine and Hygiene, vol. 58, no. 4, 2017, pp. E302-E307.
Herruzo R, Ruiz G, Gallego S, et al. VIM-Klebsiella oxytoca outbreak in a Neonatal Intensive Care Unit. This time it wasn't the drain. J Prev Med Hyg. 2017;58(4):E302-E307.
Herruzo, R., Ruiz, G., Gallego, S., Diez, J., Sarria, A., & Omeñaca, F. (2017). VIM-Klebsiella oxytoca outbreak in a Neonatal Intensive Care Unit. This time it wasn't the drain. Journal of Preventive Medicine and Hygiene, 58(4), E302-E307. https://doi.org/10.15167/2421-4248/jpmh2017.58.4.692
Herruzo R, et al. VIM-Klebsiella Oxytoca Outbreak in a Neonatal Intensive Care Unit. This Time It Wasn't the Drain. J Prev Med Hyg. 2017;58(4):E302-E307. PubMed PMID: 29707661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - VIM-Klebsiella oxytoca outbreak in a Neonatal Intensive Care Unit. This time it wasn't the drain. AU - Herruzo,R, AU - Ruiz,G, AU - Gallego,S, AU - Diez,J, AU - Sarria,A, AU - Omeñaca,F, Y1 - 2017/12/30/ PY - 2016/11/28/received PY - 2017/11/03/accepted PY - 2018/5/1/entrez PY - 2018/5/1/pubmed PY - 2018/5/1/medline KW - NICU KW - Sink (drain) KW - VIM-Klebsiella oxytoca SP - E302 EP - E307 JF - Journal of preventive medicine and hygiene JO - J Prev Med Hyg VL - 58 IS - 4 N2 - Objective: We describe an outbreak of VIM-carbapenemase Klebsiella oxytoca (VIM-Kox) in a NICU. Materials and methods: Prospective Epidemiological Surveillance:Systematically (weekly screening cultures) or on admission, if the patient had a history of previous colonization by VIM-Kox.Clinical cultures, done if infection was suspected.Other possible microorganism sources were investigated: their mothers (rectal microbiota), milk packages and preparation apparata in the lactodietary section, echocardiagram transductors, cribs, the sinks (faucets and drains), washing bowls, etc.Molecular typing was performed using the DiversiLab (bioMérieux) system on all VIM-Kox isolated from environment or patients (one by neonate). Results: We identified 20 VIM-Kox cases, the most only presented colonization, but 4 showed infection. Three of the ten sinks (drains) in our NICU, were positive for VIM-Kox. Another four drains harbored P.aeruginosa, S. maltophilia and/or Enterobacter sp. Nevertheless the VIM-Kox bacteria in the sinks (drains) were not the same as those in the patients, who showed three different strains. Conclusions: A VIM-Kox colonization or infection outbreak in a NICU is described. Rather than environment, not even drains, the source of the outbreak was other patients. The outbreak was relatively brief, as a result of the rapidness with which appropriate measures were taken and followed. SN - 1121-2233 UR - https://www.unboundmedicine.com/medline/citation/29707661/VIM_Klebsiella_oxytoca_outbreak_in_a_Neonatal_Intensive_Care_Unit__This_time_it_wasn't_the_drain_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/29707661/ DB - PRIME DP - Unbound Medicine ER -