Extended spectrum beta lactamase producing Klebsiella pneumoniae in neonatal intensive care unit.
OBJECTIVE
As infections due to Extended Spectrun beta Lactamase (ESbetaL) producing Klebsiella pneumoniae were increasing in the NICU at Karnataka Institute of Medical Sciences Hospital, Hubli, India, the present study was carried out to identify any environmental sources and the mode of transmission.


METHODS
Environmental samples from various sites were collected monthly for a period of six months.


RESULTS
ESbetaL producing K. pneumoniae were isolated from all the sites except room air at least on one occasion. ESbetaL producing K. pneumoniae was always isolated from one of the incubators, medicine trolley and sink; while at least one of the health care workers carried it in the hands four out of six times tested. ESbeta L producing K. pneumoniae with similar antibiogram were also isolated from the clinical samples obtained from the neonates.


CONCLUSIONS
Widespread use of third generation cephalosporins as a pre-emptive antibiotic for suspected cases of septicaemia may have contributed to emergence of ESbetaL producing K. pneumoniae in addition to other risk factors. ESbetaL producing K. pneumoniae have extensively colonised the environment of the NICU. Transmission of these pathogens to the neonates has probably occurred through the healthcare workers. Efforts to improve hand hygiene among the healthcare workers and mothers are urgently needed.
Krishna
B V S
BV
Department of Microbiology, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, United Kingdom. bvsk@yahoo.com
Patil
Asha B
AB
Chandrasekhar
M R
MR
D003428:Cross Infection / Q000382:microbiology* / Q000635:transmission; D024901:Drug Resistance, Multiple, Bacterial; D004866:Equipment Contamination; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007710:Klebsiella Infections / Q000382:microbiology* / Q000635:transmission; D007711:Klebsiella pneumoniae / Q000302:isolation & purification* / Q000378:metabolism; D001618:beta-Lactamases / Q000378:metabolism*
D001618:beta-Lactamases
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