Control of infection due to Klebsiella pneumoniae in an intensive care nursery. 1990

P Knight, and G Cassady
School of Primary Medical Care, University of Alabama, Huntsville.

Because of an increased incidence of necrotizing enterocolitis (NEC) temporally related to Klebsiella pneumoniae colonization noted in several infants, a study was undertaken to identify the source and to eradicate the infection. Twenty infants in the neonatal intensive care unit (NICU) and 51 in the well-baby nursery were prospectively studied. Cultures were done on all infants. In addition, cultures were done on all employees and parents who regularly visited. Our results showed an increased incidence of infection during this period--8.3% as compared with 4.79% overall. Colonization with K pneumoniae was eradicated, at least temporarily, by establishing a cohort system in both the NICU and the well-baby nursery and by the administration of antibiotics to all infants in these nurseries. Colonized parents and employees were also treated. Follow-up cultures showed clearing of Klebsiella, and the cohort system was abolished. Serotyping of all affected infants later showed that different strains were present, making it unlikely that there was a common source for the Klebsiella. (Initially the source of infection had been thought to be a mother whose premature triplets were colonized. We feel that the eradication of this organism and the subsequent decline in NEC was enhanced by the combination of cohorting and handwashing. The selected use of antibiotics may have prevented an extension of the outbreak, but this could not be proven.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007363 Intensive Care Units, Neonatal Hospital units providing continuing surveillance and care to acutely ill newborn infants. Neonatal Intensive Care Unit,Neonatal Intensive Care Units,Newborn Intensive Care Unit,Newborn Intensive Care Units,ICU, Neonatal,Neonatal ICU,Newborn ICU,Newborn Intensive Care Units (NICU),ICU, Newborn,ICUs, Neonatal,ICUs, Newborn,Neonatal ICUs,Newborn ICUs
D007710 Klebsiella Infections Infections with bacteria of the genus KLEBSIELLA. Infections, Klebsiella,Infection, Klebsiella,Klebsiella Infection
D007711 Klebsiella pneumoniae Gram-negative, non-motile, capsulated, gas-producing rods found widely in nature and associated with urinary and respiratory infections in humans. Bacillus pneumoniae,Bacterium pneumoniae crouposae,Hyalococcus pneumoniae,Klebsiella pneumoniae aerogenes,Klebsiella rhinoscleromatis
D009070 Moxalactam Broad- spectrum beta-lactam antibiotic similar in structure to the CEPHALOSPORINS except for the substitution of an oxaazabicyclo moiety for the thiaazabicyclo moiety of certain CEPHALOSPORINS. It has been proposed especially for the meningitides because it passes the blood-brain barrier and for anaerobic infections. 1-Oxacephalosporin,6059-S,Disodium Latamoxef,Disodium Moxalactam,Festamoxin,Lamoxactam,Latamoxef,Lilly 127935,Ly-127935,Ly127935,Moxalactam Disodium,S-6059,Shiomarin,1 Oxacephalosporin,6059 S,6059S,Disodium, Moxalactam,Latamoxef, Disodium,Ly 127935,Moxalactam, Disodium,S 6059,S6059
D009725 Nurseries, Hospital Hospital facilities which provide care for newborn infants. Hospital Nurseries,Hospital Nursery,Nursery, Hospital
D009741 Nursing Staff, Hospital Personnel who provide nursing service to patients in a hospital. Hospital Nursing Staff,Hospital Nursing Staffs,Nursing Staffs, Hospital,Staff, Hospital Nursing,Staffs, Hospital Nursing
D002506 Cephalexin A semisynthetic cephalosporin antibiotic with antimicrobial activity similar to that of CEPHALORIDINE or CEPHALOTHIN, but somewhat less potent. It is effective against both gram-positive and gram-negative organisms. 5-Thia-1-azabicyclo(4.2.0)oct-2-ene-2-carboxylic acid, 7-((aminophenylacetyl)amino)-3-methyl-8-oxo-, (6R-(6alpha,7beta(R*)))-,Cefalexin,Cephalexin Dihydride,Cephalexin Hemihydrate,Cephalexin Hydrochloride,Cephalexin Monohydrate,Cephalexin Monohydrochloride,Cephalexin Monohydrochloride, Monohydrate,Cephalexin, (6R-(6alpha,7alpha(R*)))-Isomer,Cephalexin, (6R-(6alpha,7beta(S*)))-Isomer,Cephalexin, (6R-(6alpha,7beta))-Isomer,Cephalexin, Monosodium Salt,Cephalexin, Monosodium Salt, (6R-(6alpha,7beta))-Isomer,Ceporexine,Palitrex
D003428 Cross Infection Any infection which a patient contracts in a health-care institution. Hospital Infections,Nosocomial Infections,Health Care Associated Infection,Health Care Associated Infections,Healthcare Associated Infections,Infection, Cross,Infections, Hospital,Infections, Nosocomial,Cross Infections,Healthcare Associated Infection,Hospital Infection,Infection, Healthcare Associated,Infection, Hospital,Infection, Nosocomial,Infections, Cross,Infections, Healthcare Associated,Nosocomial Infection
D004196 Disease Outbreaks Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS. Outbreaks,Infectious Disease Outbreaks,Disease Outbreak,Disease Outbreak, Infectious,Disease Outbreaks, Infectious,Infectious Disease Outbreak,Outbreak, Disease,Outbreak, Infectious Disease,Outbreaks, Disease,Outbreaks, Infectious Disease

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