scholarly journals Carbapenemase-Producing Enterobacteriaceae (CPE) Newborn Colonization in a Portuguese Neonatal Intensive Care Unit (NICU): Epidemiology and Infection Prevention and Control Measures

2021 ◽  
Vol 13 (2) ◽  
pp. 411-417
Author(s):  
Teresa L. Almeida ◽  
Tânia Mendo ◽  
Raquel Costa ◽  
Cristina Novais ◽  
Mónica Marçal ◽  
...  

Infections due to carbapenemase-producing Enterobacterales (CPE) are increasing worldwide and are especially concerning in a neonatal intensive care unit (NICU). Risk factors for CPE gut colonization in neonates need to be clarified. In this work, we describe the epidemiological and clinical features of CPE-colonized newborns and the infection control measures in a Portuguese NICU. We performed a prospective, observational, longitudinal, cohort study for surveillance of CPE colonization. Maternal and neonatal features of colonized newborns and surveillance strategy were described. A statistical analysis was performed with SPSS23.0, and significance was indicated by p-value ≤ 0.05. Between March and November 2019, CPE was isolated in 5.8% of 173 admitted neonates. Carbapenemase-producing Klebsiella pneumoniae were the most frequently isolated. There was no associated infection. Birth weight, gestational age, length of stay, and days of central line were the identified risk factors for CPE colonization (bivariate analysis with Student’s t-test or Mann–Whitney U test, according to normality). No independent risk factors for CPE colonization were identified in the logistic regression analysis. CPE colonization risk factors are still to be determined accurately in the neonatal population. Active surveillance and continuous infection control measures restrained the current cluster of colonized newborns and helped to prevent infection and future outbreaks.

2000 ◽  
Vol 21 (9) ◽  
pp. 605-607 ◽  
Author(s):  
Lewis M. Drusin ◽  
Barbara G. Ross ◽  
Karen Helton Rhodes ◽  
Alfred N. Krauss ◽  
Rachelle A. Scott

AbstractAn outbreak of nosocomial ringworm involved five infants in a neonatal intensive care unit. The index case was a nurse infected with Microsporum canis by her cat. After standard infection control measures were initiated, the outbreak was resolved successfully by an interdisciplinary professional collaboration of physician and veterinary dermatologists and infection control personnel.


2011 ◽  
Vol 32 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Eric J. McGrath ◽  
Teena Chopra ◽  
Nahed Abdel-Haq ◽  
Katherine Preney ◽  
Winston Koo ◽  
...  

Objective.To investigate the mode of transmission of and assess control measures for an outbreak of carbapenem-resistant (multidrug-resistant) Acinetobacter baumannii infection involving 6 premature infants.Design.An outbreak investigation based on medical record review was performed for each neonate during the outbreak (from November 2008 through January 2009) in conjunction with an infection control investigation.Setting.A 36-bed, level 3 neonatal intensive care unit in a university-affiliated teaching hospital in Detroit, Michigan.Interventions.Specimens were obtained for surveillance cultures from all infants in the unit. In addition, geographic cohorting of affected infants and their nursing staff, contact isolation, re-emphasis of adherence to infection control practices, environmental cleaning, and use of educational modules were implemented to control the outbreak.Results.Six infants (age, 10-197 days) with multidrug-resistant A. baumannii infection were identified. All 6 infants were premature (gestational age, 23-30 weeks) and had extremely low birth weights (birth weight, 1000 g or less). Conditions included conjunctivitis (2 infants), pneumonia (4 infants), and bacteremia (1 infant). One infant died of causes not attributed to infection with the organism; the remaining 5 infants were discharged home. All surveillance cultures of unaffected infants yielded negative results.Conclusions.The spread of multidrug-resistant A. baumannii infection was suspected to be due to staff members who spread the pathogen through close contact with infants. Clinical staff recognition of the importance of multidrug-resistant A. baumannii recovery from neonatal intensive care unit patients, geographic cohorting of infected patients, enhanced infection control practices, and staff education resulted in control of the spread of the organism.


2021 ◽  
Vol 28 (3) ◽  
pp. 116-123
Author(s):  
Jiyoon Jeong ◽  
Yoojin Kwun ◽  
Min-ju Kim ◽  
Sang-Ho Choi ◽  
Euiseok Jung ◽  
...  

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU).Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed.Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004).Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.


2021 ◽  
Author(s):  
ANASTASSIOS GEORGE DOUDOULAKAKIS ◽  
Iris Spiliopoulou ◽  
Nikolaos Giormezis ◽  
Garyfallia Syridou ◽  
Angeliki Nika ◽  
...  

Abstract The epidemiology of methicillin-resistant S. aureus (MRSA) colonization and infections in a 30-bed, level III university-affiliated neonatal intensive care unit was retrospectively investigated (2014-2018). Virulence, resistance genes and clonality of 46 isolates were determined by PCRs and MLST. Of 1538 neonates, 77 (5%) had a positive culture for MRSA; four bacteremias occured. One major clone was identified, ST225 (23/40, 58%), imported from the same maternity hospital. Another clone, ST217, was predominant (4/6) among colonized health care workers. Four isolates classified as ST80 were PVL-positive, four tst-positive, and two etb-positive. Strengthening of infection control measures with emphasis on hand hygiene was applied.


2001 ◽  
Vol 22 (10) ◽  
pp. 630-634 ◽  
Author(s):  
Paolo Villari ◽  
Margherita Crispino ◽  
Alessandra Salvadori ◽  
Alda Scarcella

AbstractObjective:To investigate and control a biphasic outbreak ofSerratia marcescensin a neonatal intensive care unit (NICU).Design:Epidemiological and laboratory investigation of the outbreak.Setting:The NICU of the 1,470-bed teaching hospital of the University “Federico II,” Naples, Italy.Patients:The outbreak involved 56 cases of colonization by Smarcescensover a 15-month period, with two epidemic peaks of 6 and 3 months, respectively. Fourteen (25%) of the 56 colonized infants developed clinical infections, 50% of which were major (sepsis, meningitis, or pneumonia).Methods:Epidemiological and microbiological investigations, analysis of macrorestriction pattern of genomic DNA through pulsed-field gel electrophoresis (PFGE) of clinical and environmental isolates, and institution of infection control measures.Results:Analysis of macrorestriction patterns of genomic DNA by PFGE demonstrated that the vast majority of Smarcescensisolates, including three environmental strains isolated from two handwashing disinfectants and the hands of a nurse, were of the same clonal type. The successful control of the outbreak was achieved through cohorting of noncolonized infants, isolation of Smarcescens-infectedand -colonized infants, and an intense educational program that emphasized the need for adherence to glove use and handwashing policies. The NICU remained open to new admissions.Conclusions:Outbreaks caused by Smarcescensare very difficult to eradicate. An infection control program that includes molecular typing of microorganisms and the proper dissemination among staff members of the typing results is likely to be very effective in reducing NICU-acquired infections and in controlling outbreaks caused by Smarcescens,as well as other multiresistant bacteria.


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