Asymptomatic carriage of Klebsiella pneumoniae producing extended-spectrum beta-lactamase by patients in a neurological early rehabilitation unit: management of an outbreak.
During 11 months 58 extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-Kp) isolates were grown from 10 patients on a neurological early rehabilitation unit. The patients had no signs of infection but were colonized in the nose and trachea, and unusually only one had colonization in the gut. A single clone of ESBL-Kp was identified by pulse field gel electrophoresis. Strong hygienic precautions similar to those for Methicillin-resistant Staphylococcus aureus patients prevented spread of the bacteria to other wards. However, rehabilitation for patients with severe neurological failures made it very difficult to follow hygienic requirements. Disinfection of mucous membranes was difficult. Eventually the application of a nasal spray containing povidone-iodine proved to be successful.
Holländer
R
R
Landesuntersuchungsamt für Chemie, Hygiene und Veterinärmedizin, St. Jürgenstr. 1, D-28205 Bremen, Germany.
Ebke
M
M
Barck
H
H
von Pritzbuer
E
E
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002353:Carrier State; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004352:Drug Resistance, Microbial; D004783:Environmental Microbiology; D006801:Humans; D017053:Infection Control; D007710:Klebsiella Infections / Q000453:epidemiology / Q000517:prevention & control*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D009666:Nose / Q000382:microbiology; D010814:Physical Therapy Department, Hospital / Q000706:statistics & numerical data; D011206:Povidone-Iodine / Q000627:therapeutic use; D014132:Trachea / Q000382:microbiology; D001618:beta-Lactamases
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D001618:beta-Lactamases