Outbreak of bloodstream infection with extendedspectrum ß-lactamase-producing Klebsiella pneumoniae at a Teaching Hospital
Introduction: Klebsiella pneumoniae (K. pneumoniae) is an important hospital-acquired pathogen causing severe infections in neonatal units. Several outbreaks of infection caused by multi-drug-resistant K. pneumoniae isolates have been widely reported among neonates. The aim is to investigate an outbreak of blood stream infection caused by Extended-Spectrum ß-Lactamases (ESBL) producing K.pneumoniae in a Neonatal Intensive Care Unit (NICU) at Teaching Hospital Kandy, Sri Lanka.
Materials and Methods: Blood culture samples were collected from the neonates on admission to the NICU and 2 to 3 days later on clinical suspicion of blood stream infection. The blood culture samples were processed according to the standard methods and the antibiotic susceptibility tests were carried out as per Clinical Laboratory Standards Institute (CLSI) guidelines.
Results: Of the 140 blood cultures 36 were identified as Extended-Spectrum ß-Lactamases (ESBL) producing K.pneumoniae. All the isolates were susceptible to ciprofloxacin, amikacin, netilmicin, imipenem and meropenem. Twenty eight of the 36 patients responded to treatment with a combination of amikacin and meropenem.
Conclusion: ESBL producing K.pneumoniae was responsible for this outbreak at the NICU. Knowing the susceptibility patterns of clinical isolates will allow the rational use of antibiotics, which is important in the treatment of infections with multi-drugresistant bacteria.
J Nepal Paediatr Soc 2014;34(3):230-232
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).