Journal Article

Outbreak of a Multiresistant <i>Klebsiella pneumoniae</i> Strain in an Intensive Care Unit: Antibiotic Use as Risk Factor for Colonization and Infection

Angel Asensio, Antonio Oliver, Paulino González-Diego, Fernando Baquero, Jose Claudio Pérez-Díaz, Purificación Ros, Javier Cobo, Margarita Palacios, Dolores Lasheras and Rafael Cantón

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 1, pages 55-60
Published in print January 2000 | ISSN: 1058-4838
Published online January 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313590
Outbreak of a Multiresistant Klebsiella pneumoniae Strain in an Intensive Care Unit: Antibiotic Use as Risk Factor for Colonization and Infection

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An observational study was undertaken to describe a nosocomial outbreak caused by multiresistant Klebsiella pneumoniae (MRKP). Ten patients in the pediatric intensive care unit (ICU) at a hospital in Madrid were colonized by or infected with MRKP from October 1997 to April 1998. Thirty-two patients with MRKP-negative surveillance cultures who were admitted to the ICU during the outbreak period were selected as control patients. Random amplified polymorphic DNA analysis of MRKP isolates revealed patterns that were indistinguishable from each other. After identification of colonized patients by surveillance cultures and implementation of standard and contact precautions, the outbreak was controlled. An age <12 weeks (odds ratio [OR], 13.1) and previous treatment with third-generation cephalosporins and aminoglycosides (OR, 31.2) were independently associated with MRKP colonization and/or infection. Individual exposure to antibiotics, irrespective of other clinical determinants, is a risk factor for MRKP acquisition. Screening high-risk patients during outbreaks and reducing the use of third-generation cephalosporins and amino-glycosides contribute to the control of these epidemics.

Journal Article.  3938 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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