title: Outbreak of extended spectrum beta-lactamase-producing Klebsiella pneumoniae in an intensive care unit (Brest).
abstract: BACKGROUND
  We had for aim to describe control and investigation of an outbreak caused by a strain of Extended spectrum beta-lactamase producing Klebsiella pneumoniae in intensive care units of the Brest teaching hospital.
  
  
  METHODS
  The case definition was a patient infected by or carrying the epidemic strain. Control measures and investigations are presented. A case-control study was conducted in the surgical intensive care unit. Each case was matched with two controls based on admission times in the unit. The study focused on diagnostic and therapeutic procedures, and potential contacts with healthcare workers, in this context of cross transmission.
  
  
  RESULTS
  Between February and May 2011, nine cases were reported in the surgical ICU and two in the medical ICU. Eighteen controls were matched with the nine surgical ICU cases. Several factors were found to be statistically associated with infection or colonization by the epidemic strain: the surgical block in which patients had been operated and the ward of first hospitalization; the number of trans-esophageal and trans-thoracic echocardiographies, of central venous catheter insertions, and of surgical operations; intubation. The total number of invasive procedures was also found to be statistically higher among cases.
  
  
  CONCLUSIONS
  This study identified factors associated with colonization or infection by the epidemic strain. These factors might have been involved in the transmission tree, and be vulnerable elements for the prevention of nosocomial infections and colonisations, and their epidemic spread.
authors.affiliation: Équipe opérationnelle d'hygiène, CHRU de Brest, Brest, France. marc.carpentier@chu-brest.fr
authors.forename: M
authors.initials: M
authors.lastname: Carpentier
authors.forename: V
authors.initials: V
authors.lastname: Appere
authors.forename: P
authors.initials: P
authors.lastname: Saliou
authors.forename: A
authors.initials: A
authors.lastname: de Tinteniac
authors.forename: H
authors.initials: H
authors.lastname: Floch
authors.forename: F
authors.initials: F
authors.lastname: Le Gall
authors.forename: M
authors.initials: M
authors.lastname: Cosse
authors.forename: M
authors.initials: M
authors.lastname: El Bouyousfi
authors.forename: R
authors.initials: R
authors.lastname: Baron
authors.forename: J-M
authors.initials: JM
authors.lastname: Boles
authors.forename: S
authors.initials: S
authors.lastname: Jourdain
authors.forename: B
authors.initials: B
authors.lastname: Lejeune
authors.forename: B
authors.initials: B
authors.lastname: Nancy
authors.forename: G
authors.initials: G
authors.lastname: Prat
authors.forename: D
authors.initials: D
authors.lastname: Tande
authors.forename: M
authors.initials: M
authors.lastname: Virmaux
authors.forename: J-P
authors.initials: JP
authors.lastname: Wargnier
authors.forename: R
authors.initials: R
authors.lastname: Garlantézec
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000517:prevention & control; D007711:Klebsiella pneumoniae / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001618:beta-Lactamases