title: The higher disinfectant resistance of nosocomial isolates of Klebsiella oxytoca: how reliable are indicator organisms in disinfectant testing?
abstract: The Children's Clinic in Giessen, Germany recently reported several severe infections with Klebsiella oxytoca resulting in deaths of two neonates. The putative source of the infections was a contaminated infusion solution. The resistance to disinfectant of the K. oxytoca isolates was investigated in three independent laboratories and was indeed found to be significantly increased. Comparative tests with standard strains of K. oxytoca and other recommended bacterial surrogates showed the disinfection procedures used were fully effective. The higher resistance of the nosocomial isolates may have developed due to improper handling and storage of the cleaning utensils. This report describes the events and draws conclusions concerning the use of disinfectants, the treatment of cleaning utensils, the reliability of procedures for testing disinfectants, and suggests additional measures.
authors.affiliation: Committee for Disinfectants, German Society for Hygiene and Microbiology (DGHM), c/o Institute of Hygiene and Public Health, University of Bonn, Bonn, Germany. juergen.gebel@ukb.uni-bonn.de
authors.forename: J
authors.initials: J
authors.lastname: Gebel
authors.forename: H-G
authors.initials: HG
authors.lastname: Sonntag
authors.forename: H-P
authors.initials: HP
authors.lastname: Werner
authors.forename: V
authors.initials: V
authors.lastname: Vacata
authors.forename: M
authors.initials: M
authors.lastname: Exner
authors.forename: T
authors.initials: T
authors.lastname: Kistemann
mesh_terms: D000293:Adolescent; D003428:Cross Infection / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D004202:Disinfectants / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004866:Equipment Contamination; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007709:Klebsiella / Q000187:drug effects* / Q000302:isolation & purification; D007710:Klebsiella Infections / Q000209:etiology* / Q000401:mortality
chemical_list: D004202:Disinfectants