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Investigation of an outbreak caused by antibiotic-susceptible Klebsiella oxytoca in a neonatal intensive care unit in Norway.
Acta Paediatr. 2019 01; 108(1):76-82.AP

Abstract

AIM

Klebsiella spp. have been stated to be the most frequent cause of neonatal intensive care unit (NICU) outbreaks. We report an outbreak of Klebsiella oxytoca in a NICU at a tertiary care hospital in Norway between April 2016 and April 2017. This study describes the outbreak, infection control measures undertaken and the molecular methods developed.

METHODS

The outbreak prompted detailed epidemiological and microbial investigations, where whole-genome sequencing (WGS) was particularly useful for both genotyping and development of two new K. oxytoca-specific real-time PCR assays. Routine screening of patients, as well as sampling from numerous environmental sites, was performed during the outbreak. A bundle of infection control measures was instigated to control the outbreak, among them strict cohort isolation.

RESULTS

Five neonates had symptomatic infection, and 17 were found to be asymptomatically colonised. Infections varied in severity from conjunctivitis to a fatal case of pneumonia. A source of the outbreak could not be determined.

CONCLUSION

This report describes K. oxytoca as a significant pathogen in a NICU outbreak setting and highlights the importance of developing appropriate microbiological screening methods and implementing strict infection control measures to control the outbreak in a setting where the source could not be identified.

Authors+Show Affiliations

Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. Department of Neonatal intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.Unit of Infection Control, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. Unit of Infection Control, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30238492

Citation

Rønning, Torunn Gresdal, et al. "Investigation of an Outbreak Caused By Antibiotic-susceptible Klebsiella Oxytoca in a Neonatal Intensive Care Unit in Norway." Acta Paediatrica (Oslo, Norway : 1992), vol. 108, no. 1, 2019, pp. 76-82.
Rønning TG, Aas CG, Støen R, et al. Investigation of an outbreak caused by antibiotic-susceptible Klebsiella oxytoca in a neonatal intensive care unit in Norway. Acta Paediatr. 2019;108(1):76-82.
Rønning, T. G., Aas, C. G., Støen, R., Bergh, K., Afset, J. E., Holte, M. S., & Radtke, A. (2019). Investigation of an outbreak caused by antibiotic-susceptible Klebsiella oxytoca in a neonatal intensive care unit in Norway. Acta Paediatrica (Oslo, Norway : 1992), 108(1), 76-82. https://doi.org/10.1111/apa.14584
Rønning TG, et al. Investigation of an Outbreak Caused By Antibiotic-susceptible Klebsiella Oxytoca in a Neonatal Intensive Care Unit in Norway. Acta Paediatr. 2019;108(1):76-82. PubMed PMID: 30238492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigation of an outbreak caused by antibiotic-susceptible Klebsiella oxytoca in a neonatal intensive care unit in Norway. AU - Rønning,Torunn Gresdal, AU - Aas,Christina Gabrielsen, AU - Støen,Ragnhild, AU - Bergh,Kåre, AU - Afset,Jan Egil, AU - Holte,Mari Sagli, AU - Radtke,Andreas, Y1 - 2018/10/09/ PY - 2018/09/07/received PY - 2018/09/17/accepted PY - 2018/9/22/pubmed PY - 2018/9/22/medline PY - 2018/9/22/entrez KW - Klebsiella oxytoca KW - Infection control measures KW - Neonatal intensive care unit KW - Outbreak KW - Whole-genome sequencing SP - 76 EP - 82 JF - Acta paediatrica (Oslo, Norway : 1992) JO - Acta Paediatr. VL - 108 IS - 1 N2 - AIM: Klebsiella spp. have been stated to be the most frequent cause of neonatal intensive care unit (NICU) outbreaks. We report an outbreak of Klebsiella oxytoca in a NICU at a tertiary care hospital in Norway between April 2016 and April 2017. This study describes the outbreak, infection control measures undertaken and the molecular methods developed. METHODS: The outbreak prompted detailed epidemiological and microbial investigations, where whole-genome sequencing (WGS) was particularly useful for both genotyping and development of two new K. oxytoca-specific real-time PCR assays. Routine screening of patients, as well as sampling from numerous environmental sites, was performed during the outbreak. A bundle of infection control measures was instigated to control the outbreak, among them strict cohort isolation. RESULTS: Five neonates had symptomatic infection, and 17 were found to be asymptomatically colonised. Infections varied in severity from conjunctivitis to a fatal case of pneumonia. A source of the outbreak could not be determined. CONCLUSION: This report describes K. oxytoca as a significant pathogen in a NICU outbreak setting and highlights the importance of developing appropriate microbiological screening methods and implementing strict infection control measures to control the outbreak in a setting where the source could not be identified. SN - 1651-2227 UR - https://www.unboundmedicine.com/medline/citation/30238492/Investigation_of_an_outbreak_caused_by_antibiotic_susceptible_Klebsiella_oxytoca_in_a_neonatal_intensive_care_unit_in_Norway_ L2 - https://doi.org/10.1111/apa.14584 DB - PRIME DP - Unbound Medicine ER -
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