Enterobacteriaceae Infections of Very Low Birth Weight Infants in Polish Neonatal Intensive Care Units

Wójkowska‐Mach, Jadwiga; Chmielarczyk, Agnieszka; Borszewska−Kornacka, Maria Katarzyna; Domańska, Joanna; Gadzinowski, Janusz; Gulczyńska, Ewa; Nowiczewski, Marek; Helwich, Ewa; Kordek, Agnieszka; Pawlik, Dorota; Jursa-Kulesza, Joanna; Giedrys-Kalemba, Stefania; Szczapa, Jerzy; Heczko, Piotr B

doi:10.1097/inf.0b013e318287fe2a

Cited by 19 publications

(16 citation statements)

References 24 publications

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“…However, compared to our results most publications show higher colonization rates. In a recent study from Poland in a cohort of 910 newborns similar to our results Escherichia coli ESBL and Klebsiella pneumoniae ESBL were the most common pathogens [ 28 ] . In a surveillance study from Italy among 210 neonates admitted at the NICU 116 (55.2 %) were colonized with MRPs [ 20 ] .…”

supporting

confidence: 86%

Colonization and Infection due to Multi-resistant Bacteria in Neonates: A Single Center Analysis

Haase

Worlitzsch²,

Schmidt

et al. 2013

Klin Padiatr

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▼ Background: In the last years the prevalence of multi-resistant pathogens (MRPs) has increased. Systemic infections remain important for neonatal morbidity and mortality. Patients: Neonates born between January 2011 and December 2012 and admitted to the neonatology before their tenth day of life were included into this retrospective analysis. Vancomycinresistant Enterococci, Methicillin-resistant Staphylococcus aureus, Gram-negative bacilli with Extend Spectrum Beta Lactamase or AMP-C resistance were defi ned as multi-resistant pathogens (MRPs). MRP positive and negative patients were analyzed regarding clinical risk factors and the incidence of systemic infections. Results: 635 neonates were admitted during the analysis period. In 31 patients MRPs were detected. 2 patients developed MRP-associated infections. Both were discharged without long term health risks. Low gestational age and need for mechanical ventilation were risk factors for colonization with MRPs in the univariat analysis. The incidence density (per 1 000 patient days) for all MRE increased from 0.76 in 2011 to 3.51 in 2012. In contrast the sepsis rate remained stable (14.9 % and 14.2 %). 2 MRP colonization clusters were detected by routine microbiology swabs. Both could be controlled by appropriate hygienic measures. Conclusions:The prevalence of Gram-negative MRPs increased in neonates. Microbiological screening seems to be helpful for early detection of colonization and thus prevention of nosocomial infections with MRPs. Despite the increased attention towards the problems associated with multiresistant bacteria, there are still major eff orts needed for prevention and early treatment of sepsis with non-resistant bacteria.

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supporting

confidence: 86%

Colonization and Infection due to Multi-resistant Bacteria in Neonates: A Single Center Analysis

Haase

Worlitzsch²,

Schmidt

et al. 2013

Klin Padiatr

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“…Według niektórych autorów pałeczki K. pneumoniae są drugim, po Escherichia coli, gatunkiem pałeczek z rodziny Enterobacteriaceae odpowiedzialnym za zakażenia u chorych leczonych na OAiIT [5,6,9]. Główne postaci zakażeń tymi bakteriami to: zakażenia krwi, układu moczowego, odrespiratorowe zapalenie płuc, zakażenia miejsca operowanego [10].…”

Section: Dyskusjaunclassified

Częstość zakażeń i kolonizacji Klebsiella pneumoniae izolowanych od chorych leczonych na oddziale anestezjologii i intensywnej terapii

Sękowska

Gospodarek²,

Kusza³

2014

Anaesthesiol Intensive Ther

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Należy cytować anglojęzyczną wersję artykułu z: Sękowska A, Gospodarek E, Kusza K: The prevalence of infections and colonisation with Klebsiella pneumoniae strains isolated in ICU patients. Anaesthesiol Intensive Ther 2014; 46: 280-283 Częstość zakażeń i kolonizacji Klebsiella pneumoniae izolowanych od chorych leczonych na oddziale anestezjologii i intensywnej terapii Background: Klebsiella spp. are among the bacteria most commonly isolated from patients with infections in ICUs. The source of these infections may be the microflora of the patient or the hospital environment. Increasingly, Klebsiella strains are also being isolated from epidemic outbreaks. This situation is largely the result of widespread, irrational antibiotic use, the virulence of the bacterial strains and their ability to survive in the hospital environment. The purpose of this dissertation was to estimate the prevalence of Klebsiella pneumoniae strains isolated from patients hospitalised in a single ICU. Methods: Seventy-eight isolates of K. pneumoniae were studied. The identification and the susceptibility to selected antibiotics were tested by an automated system, VITEK2 Compact. For the analysed strains, the production of different beta-lactamases was noted. Results: Production of ESBL was detected in 64.1% of the K. pneumoniae strains isolated from infections and 74.4% from rectal swabs. Most of the strains were susceptible to imipenem (97.7%) and meropenem (96.1%). Sixty-nine (57.0%) of the analysed strains were identified as multidrug resistant. Conclusion: Most of the analysed Klebsiella pneumoniae strains produced ESBL-beta-lactamases. The frequency of colonisation and infection with multidrug resistant strains of K. pneumoniae in patients hospitalised in the ICU is very high.

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“…Production of extended-spectrum ␤-lactamases (ESBLs) is the most common mechanism of ESC resistance in K. pneumoniae, and most of the ESCRKP outbreaks reported for NICU settings have been caused by ESBL-producing strains (6)(7)(8)(9)(10)(11)(12)(13)(14). Production of other ␤-lactamases, such as AmpC-type ␤-lactamases (ACBLs), can also be responsible for ESC-resistant phenotypes in K. pneumoniae, but the number of reported outbreaks caused by AmpCproducing ESCRKP is considerably more limited.…”

mentioning

confidence: 99%

Large Oligoclonal Outbreak Due to Klebsiella pneumoniae ST14 and ST26 Producing the FOX-7 AmpC β-Lactamase in a Neonatal Intensive Care Unit

et al. 2013

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A large outbreak caused by expanded-spectrum cephalosporin-resistant Klebsiella pneumoniae (ESCRKP) was observed in a neonatal intensive care unit (NICU) in central Italy. The outbreak involved 127 neonates (99 colonizations and 28 infections, with seven cases of sepsis and two deaths) over a period of more than 2 years (February 2008 to April 2010). Characterization of the 92 nonredundant isolates that were available for further investigation revealed that all of them except one produced the FOX-7 AmpC-type ␤-lactamase and belonged to either sequence type 14 (ST14) or ST26. All of the FOX-7-positive isolates were resistant to cefotaxime, ceftazidime, and piperacillin-tazobactam, while 76% were susceptible to cefepime, 98% to ertapenem, 99% to meropenem, and 100% to imipenem. The two carbapenem-nonsusceptible isolates had alterations in the genes encoding outer membrane proteins K35 and K36, which resulted in truncated and likely nonfunctional proteins. The outbreak was eventually controlled by the reinforcement of infection control measures based on a multitiered interventional approach. This is the first report of a large NICU outbreak caused by ESCRKP producing an AmpC-type enzyme. This study demonstrates that AmpCtype enzyme-producing strains can cause large outbreaks with significant morbidity and mortality effects (the mortality rate at 14 days was 28.5% for episodes of sepsis), and it underscores the role of laboratory-based surveillance and infection control measures to contain similar episodes.

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Enterobacteriaceae Infections of Very Low Birth Weight Infants in Polish Neonatal Intensive Care Units

Cited by 19 publications

References 24 publications

Colonization and Infection due to Multi-resistant Bacteria in Neonates: A Single Center Analysis

Colonization and Infection due to Multi-resistant Bacteria in Neonates: A Single Center Analysis

Częstość zakażeń i kolonizacji Klebsiella pneumoniae izolowanych od chorych leczonych na oddziale anestezjologii i intensywnej terapii

Large Oligoclonal Outbreak Due to Klebsiella pneumoniae ST14 and ST26 Producing the FOX-7 AmpC β-Lactamase in a Neonatal Intensive Care Unit

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