title: Outbreak of extended-spectrum β-lactamase-producing Klebsiella oxytoca infections associated with contaminated handwashing sinks(1).
abstract: Klebsiella oxytoca is primarily a health care-associated pathogen acquired from environmental sources. During October 2006-March 2011, a total of 66 patients in a hospital in Toronto, Ontario, Canada, acquired class A extended-spectrum β-lactamase-producing K. oxytoca with 1 of 2 related pulsed-field gel electrophoresis patterns. New cases continued to occur despite reinforcement of infection control practices, prevalence screening, and contact precautions for colonized/infected patients. Cultures from handwashing sinks in the intensive care unit yielded K. oxytoca with identical pulsed-field gel electrophoresis patterns to cultures from the clinical cases. No infections occurred after implementation of sink cleaning 3×/day, sink drain modifications, and an antimicrobial stewardship program. In contrast, a cluster of 4 patients infected with K. oxytoca in a geographically distant medical ward without contaminated sinks was contained with implementation of active screening and contact precautions. Sinks should be considered potential reservoirs for clusters of infection caused by K. oxytoca.
authors: University of Toronto, Toronto, Ontario, Canada.
authors: Christopher
authors: C
authors: Lowe
authors: Barbara
authors: B
authors: Willey
authors: Anna
authors: A
authors: O'Shaughnessy
authors: Wayne
authors: W
authors: Lee
authors: Ming
authors: M
authors: Lum
authors: Karen
authors: K
authors: Pike
authors: Cindy
authors: C
authors: Larocque
authors: Helen
authors: H
authors: Dedier
authors: Lorraine
authors: L
authors: Dales
authors: Christine
authors: C
authors: Moore
authors: Allison
authors: A
authors: McGeer
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004866:Equipment Contamination; D006235:Hand Disinfection / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D041121:Klebsiella oxytoca / Q000145:classification / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification; D009864:Ontario / Q000453:epidemiology; D014881:Water Supply; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D001618:beta-Lactamases