Journal Article

Characterization of an Outbreak Due to Extended-Spectrum <i>β</i>-Lactamase-Producing <i>Klebsiella pneumoniae</i> in a Pediatric Intensive Care Unit Transplant Population

Jill A. Rebuck, Keith M. Olsen, Paul D. Fey, Alan N. Langnas and Mark E. Rupp

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 6, pages 1368-1372
Published in print December 2000 | ISSN: 1058-4838
Published online December 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/317474
Characterization of an Outbreak Due to Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae in a Pediatric Intensive Care Unit Transplant Population

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Limited information exists regarding Klebsiella pneumoniae's production of an extended-spectrum β-lactamase (KP-ESBL) in pediatric patients, particularly solid-organ transplant recipients. This study characterized the microbiological, epidemiological, and clinical features of a KP-ESBL outbreak in children receiving a liver transplant, an intestinal transplant, or both. All children found to have microbiologically confirmed K. pneumoniae during a 21-month period were reviewed. ESBL production was defined by double-disk diffusion, and 6 distinct pulsed-field gel electrophoresis patterns were identified. Fifty-six percent of the transplant patients we studied developed KP-ESBL, representing 87% of all microbiologically confirmed cases at our institution. As compared with 16 control transplant patients who were negative for KP-ESBL, the 20 transplant patients who acquired KP-ESBL were younger (aged ⩽5 years; 80.0% vs. 43.8%, P = .038) and experienced placement of ⩾3 central venous catheters before recovery of the first K. pneumoniae isolate (73.7% vs. 18.8%, P = .002). This study suggests that children who receive liver or intestinal transplants are at high risk for KP-ESBL acquisition.

Journal Article.  3744 words. 

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

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