Molecular-epidemiologic study on outbreak of colonization by extended spectrum beta-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit.
10.3345/kjp.2006.49.2.150
- Author:
Nu Lee JUN
1
;
Mi Na KIM
;
Jae Sim JEONG
;
Yang Soo KIM
;
Ellen Ai Rhan KIM
;
Ki Soo KIM
;
Soo Young PI
Author Information
1. Division of Neonatology, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. arkim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Extended spectrum beta-lactamase producing K. pneumoniae;
Pulsed-field-gel-electrophoresis;
Colonization;
Neonatal intensive care unit
- MeSH:
beta-Lactamases*;
Clone Cells;
Colon*;
DNA;
Electrophoresis, Gel, Pulsed-Field;
Follow-Up Studies;
Humans;
Infant;
Infant, Newborn;
Infection Control;
Intensive Care, Neonatal*;
Klebsiella pneumoniae*;
Klebsiella*
- From:Korean Journal of Pediatrics
2006;49(2):150-156
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aims of this study included assessment of molecular-epidemiologic features during an outbreak of colonization of extended spectrum beta-lactamase producing Klebsiella pneumoniae(ESBL-KPN) and re-evaluation of their colonized status one year later. METHODS: Rectal swab cultures for ESBL-KPN from all hospitalized infants and newly admitted infants were obtained during the outbreak of colonization from July to December, 2000. The pattern of XbaI-digested chromosomal DNA of isolates were analyzed by pulsed-field gel electrophoresis. Weekly rectal swab cultures were obtained during the outbreak until patients were either discharged or decolonized. Patients discharged after being colonized had follow up stool cultures a year later. RESULTS: A total of 80 patients(28.5 percent) were colonized. Of those, 53 whose pulsed-field gel electrophoresis(PFGE) was possible only once, were ESBL-KPN grouped into six cluster clones and 10 single clones:28 patients(52.8 percent) were colonized with type A, the most common clone, followed by type B in 11 patients(20.8 percent). Of those 12 patients in whom serial PFGE was done more than twice, type A was predominant. Narrowed-down in strains occurred from types A, B, C, D and three single clones at initiation of the study into types A and type B after three months of strict infection control. Among 75 patients(93.7 percent) who were sent home after being colonized, 30 patients were re-called for stool cultures a year later:All of them were decolonized. CONCLUSION: This study demonstrates the importance of infection control as the diversity of ESBL-KPN strains could be narrowed into fewer strains. Colonization of ESBL-KPN could be reversed upon return to the community.
