A cluster of nosocomial Klebsiella pneumoniae bloodstream infections in a neonatal intensive care department: identification of transmission and intervention

A cluster of nosocomial Klebsiella pneumoniae bloodstream infections in a neonatal intensive care department: identification of transmission and intervention Original Research Article Pages 424-430 Petra Gastmeier, Katrin Groneberg, Klaus Weist, Henning Rüden Close Close preview | Purchase PDF (199 K) | Related articles | Related reference work articles AbstractAbstract | Figures/TablesFigures/Tables | ReferencesReferences Abstract Objective We sought to determine the cause and mode of transmission of a cluster of bloodstream infections as a result of Klebsiella pneumoniae. Design and setting We conducted a prospective cohort study in a neonatal intensive care department from May 1999 to December 2000. Methods We performed surveillance of nosocomial infections, and clinical and environmental investigations. Results During an 8-week period, 5 cases of K pneumoniae bloodstream infections were observed, at least 3 of them belonging to the same genotype. Before the second case developed any symptoms of infection, the same strain had also been found in the patient environment. Intervention measures were, therefore, immediately introduced. Further cases, however, occurred in the following weeks. Even after further intervention activities and the end of the outbreak, the same strain was discovered in environmental samples from a stethoscope and a nurseʹs hand. Conclusions Even where there is acute awareness of the problem and a generally high infection control level in a department, it is difficult to change behavior in such a way that further nosocomial infections can be totally excluded. Article Outline • Methods • The NICU • Microbiologic investigation • Typing of clinical samples • Environmental samples • Results and intervention • Typing of clinical samples • Environmental samples • Intervention • Discussion • References