title: Molecular epidemiology of gram-negative bacilli from infected neonates and health care workers' hands in neonatal intensive care units.
abstract: We sought to characterize the molecular epidemiology of gram-negative bacilli (GNB) causing infections in infants and associated with carriage on nurses' hands after hand hygiene was performed. From March 2001 to January 2003, GNB caused 192 (34%) of 562 hospital-acquired infections in the 2 participating neonatal intensive care units (NICUs) and were isolated from the hands of 45 (38%) of 119 nurses. Five species--Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Serratia marcescens and Enterobacter cloacae, all of which were typed by pulsed-field gel electrophoresis--caused 169 (88%) of 192 of GNB infections. Overall, 58% of infections were caused by unique strains not cultured from other infants or nurses, and 31% of infections were part of unrecognized molecular clusters. In contrast, only 9% of strains that caused infections were cultured from nurses' hands. These data suggest that practices in addition to hand hygiene are needed to prevent horizontal transmission of GNB in the NICU.
authors.affiliation: Department of Pediatrics, Columbia University, New York, New York 10032, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Waters
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
authors.forename: Fann
authors.initials: F
authors.lastname: Wu
authors.forename: Pablo
authors.initials: P
authors.lastname: San Gabriel
authors.forename: Janet
authors.initials: J
authors.lastname: Haas
authors.forename: Jeannie
authors.initials: J
authors.lastname: Cimiotti
authors.forename: Phyllis
authors.initials: P
authors.lastname: Della-Latta
authors.forename: Lisa
authors.initials: L
authors.lastname: Saiman
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D018562:Disease Transmission, Infectious; D016521:Electrophoresis, Gel, Pulsed-Field; D006090:Gram-Negative Bacteria / Q000235:genetics*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D006225:Hand / Q000382:microbiology; D006235:Hand Disinfection; D006282:Health Personnel; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D017592:Skin Care