title: Outbreak of ampicillin/piperacillin-resistant Klebsiella pneumoniae in a neonatal intensive care unit (NICU): investigation and control measures.
abstract: Klebsiella pneumoniae is a frequent cause of infectious outbreaks in Neonatal Intensive Care Units (NICUs). The aim of this paper is to describe an outbreak occurred in a 13-bed NICU and the control measures adopted in order to interrupt the chain of transmission. We described the microbiological investigations, the NICU staff compliance to the infection control measures by means of a specifically designed check-list and the control measures adopted. Six cases of primary bloodstream infections sustained by ampicillin/piperacillin-resistant Klebsiella pneumoniae were observed over a two-month period. One culture obtained from a 12% saccarose multiple-dose solution allowed the growth of Klebsiella pneumoniae. During the inspections performed by the Hospital Infection Control Team, using the check-list for the evaluation of the NICU staff compliance to the infection control measures, several breaches in the infection control policy were identified and control measures were adopted. In our case the definition of a specific check-list led to the adoption of the correct control measures. Further studies would be helpful in order to develop a standard check-list able to identify critical flows in the adhesion to the guidelines. It could be used in different NICUs and allow to obtain reproducible levels of infection control.
authors: Health Care Management, Bologna Local Health Trust, Via Castiglione 29, 40124 Bologna, Italy. giuliana.fabbri@ausl.bologna.it
authors: Giuliana
authors: G
authors: Fabbri
authors: Manuela
authors: M
authors: Panico
authors: Laura
authors: L
authors: Dallolio
authors: Roberta
authors: R
authors: Suzzi
authors: Matilde
authors: M
authors: Ciccia
authors: Fabrizio
authors: F
authors: Sandri
authors: Patrizia
authors: P
authors: Farruggia
mesh_terms: D000667:Ampicillin; D000900:Anti-Bacterial Agents; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D004269:DNA, Bacterial / Q000032:analysis; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D017053:Infection Control / Q000379:methods; D007363:Intensive Care Units, Neonatal; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D007711:Klebsiella pneumoniae / Q000235:genetics / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D010878:Piperacillin
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D000667:Ampicillin; D010878:Piperacillin