title: A nursery outbreak of multiple-aminoglycoside-resistant Escherichia coli.
abstract: In the neonatal intensive care unit (NICU) of one hospital, 16 infants became colonized or infected with multiply-resistant Escherichia coli (MR-E.coli) over an 8-month period. Isolates were obtained from blood, urine, and sputum of three patients and from rectal surveillance cultures of 13 patients. The one patient with the blood isolate died. A matched case-control study identified continuous feeding (nine of 16 cases vs. one of 16 controls, p less than or equal to 0.001) and receipt of aminoglycosides (p less than or equal to 0.03) as risk factors. For case-babies not exposed to continuous feeding, duration of bolus feeding was significantly greater than for their controls (cases, 22 days; controls, 7 days; p less than or equal to 0.02). All 16 isolates were the same serotype and were resistant to amikacin, tobramycin, kanamycin, and gentamicin. The epidemiologic investigation suggested that MR-E. coli may have spread from person-to-person on the hands of personnel and that MR-E. coli persisted in the NICU for 8 months until effective control measures were instituted.
mesh_terms: D000617:Aminoglycosides / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology / Q000635:transmission*; D004196:Disease Outbreaks / Q000453:epidemiology*; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D006745:Hospital Bed Capacity, 300 to 499; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007629:Kentucky
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents