Klebsiella type 33 septicemia in an infant intensive care unit

Hable, Kathleen A.; Matsen, John M.; Wheeler, Donald J.; Hunt, Carl E.; Quie, Paul G.

doi:10.1016/s0022-3476(72)80002-7

Cited by 68 publications

(20 citation statements)

References 10 publications

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“…infections in general, [12][13][14][15] we found the gastrointestinal tract to be a common and important site of colonization. Morgan et al 5 found only two of 12 infected infants did not have rectal colonization at the time of sepsis; all our infants with ESBL Klebsiella sp.…”

Section: Discussionmentioning

confidence: 75%

A case-control study of risk factors associated with rectal colonization of extended-spectrum beta-lactamase producing sp. in newborn infants

Lim

2005

Journal of Hospital Infection

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Section: Discussionmentioning

confidence: 75%

A case-control study of risk factors associated with rectal colonization of extended-spectrum beta-lactamase producing sp. in newborn infants

Lim

2005

Journal of Hospital Infection

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“…1970;Lancet, 1971), and multiply antibiotic resistant strains of K. aerogenes have caused serious outbreaks of infection which have often been extremely difficult to control (Price & Sleigh, 1970;Hable et al 1972;Hill, Hunt & Matsen, 1974;Curie et al 1978).…”

Section: Introductionmentioning

confidence: 99%

The development and assessment of a bacteriocin typing method forKlebsiella

Edmondson

Cooke

1979

J. Hyg.

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SUMMARYKlebsiellas are generally typed by the method of capsular serotyping but, although this is a reliable method, it is time consuming, requires the production of a large number of antisera and is not generally available. For this reason another method for typing klebsiellas was sought.A bacteriocin typing method involving mitomycin C induction was developed and the cultural conditions giving optimum klebecin production and the best methods of testing the sensitivity of the organisms to klebecins were determined.Of 190 klebsiella strains screened for bacteriocinogeny, only 68 (35.8 %) produced klebecin and after calculation of similarity values by computer analysis, a typing set of 15 producers was selected. This typing set allowed over 96 % of klebsiella strains to be typed and tests of the reproducibility of the method and the variability of typing patterns in natural populations of klebsiella indicated that results of acceptable accuracy could be obtained, while retaining good discrimination if two or more differences were required between patterns before they were regarded as distinct.A complete set of capsular antisera were prepared, enabling the results obtained from klebecin typing to be compared with those from serotyping. There was generally close agreement between the results from the two typing methods and greater discrimination was obtained between similar strains when the two methods were combined. Klebecin typing and serotyping revealed relationships between strains from five outbreaks of infection, and strains of the same serotype from different hospitals could frequently be distinguished by their klebecin typing patterns.

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“…Intestinal colonization has been documented and implicated as an important reservoir of Klebsiella in many outbreaks (1,7,8,18). In this outbreak 606 prevalence cultures of the pharynx and rectum were taken from 364 presumed uninfected and uncolonized patients, and only 6 cases (1.6%) of asymptomatic stool colonization were found.…”

mentioning

confidence: 98%

Nosocomial Multiply Resistant Klebsiella pneumoniae : Epidemiology of an Outbreak of Apparent Index Case Origin

Gerding

Buxton

Hughes

et al. 1979

Antimicrob Agents Chemother

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A nosocomial epidemic of multiply resistant (MR) Klebsiella pneumoniae characterized by resistance to gentamicin, tobramycin, kanamycin, cephalothin, chloramphenicol, and ampicillin occurred in a Veterans Administration hospital from 1975 to 1977. A total of 66 infected or colonized patients were observed in a 2-year period; there were 43 urinary tract infections, 13 wound or soft tissue infections, 8 pneumonias, and 6 patients with only asymptomatic stool colonization. Four patients had both pneumonia and a urinary tract infection. There were five secondary bacteremias. The majority of MR K. pneumoniae strains were type 30, but types 17, 21, and 23 and nontypable organisms were also recovered. Other gram-negative bacilli with the same antibiotic resistance pattern were isolated from 14 patients. Seven MR K. pneumoniae and three resistant Escherichia coli isolates were shown to transfer resistance to E. coli K-12. MR K. pneumoniae-infected patients were seriously ill, had long hospitalization times (mean, 67 days), and were in close geographic proximity to other cases. Compared with controls, cases more frequently had prior antibiotic treatment and urinary catheters, but not respiratory instrumentation, nasogastric tubes, or antacid treatment. The apparent source of the outbreak was traced to an index case who entered the hospital with an MR K. pneumoniae urinary tract infection. Asymptomatic gastrointestinal carriage without infection elsewhere was infrequent (1.6% of cultured patients), but 78% of patients with MR K. pneumoniae infections at other sites also had the organism in their stools. Hospital antibiotic usage was unchanged before and during the outbreak. The identification of an index case and relative lack of asymptomatic stool carriers are unique features of this plasmid-mediated MR K. pneumoniae epidemic. Although this MR K. pneumoniae outbreak appeared to be controlled by the use of isolation techniques, a simultaneous increase in gentamicin resistance among other gram-negative organisms was observed.Klebsiella pneumoniae is the most common cause of nosocomial respiratory tract infections and the second most frequent cause of gramnegative bacteremias and urinary tract infections (4, 10). Certain aspects of the epidemiology of these infections seem clear. Intestinal colonization often precedes clinical evidence of infection, and bacteria in intestinal tracts of patients may serve as an important reservoir for Klebsiella within a hospital (18). How outbreaks due to multiple-drug-resistant (MR) Klebsiella originate is not clear. Increased use of broad-spectrum antibiotics was an associated factor in several instances, but a cause-and-effect relationship was not well established (6,12). In other outbreaks, no changes in selective antibiotic pressures were observed, and the source of the epidemic strain was not determined.During the summer of 1975 the hospital epidemiologist at the 800-bed Minneapolis Veterans Administration Hospital first noted gentamicin resistance among Klebsiella isolates from patie...

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Klebsiella type 33 septicemia in an infant intensive care unit

Cited by 68 publications

References 10 publications

A case-control study of risk factors associated with rectal colonization of extended-spectrum beta-lactamase producing sp. in newborn infants

A case-control study of risk factors associated with rectal colonization of extended-spectrum beta-lactamase producing sp. in newborn infants

The development and assessment of a bacteriocin typing method forKlebsiella

Nosocomial Multiply Resistant Klebsiella pneumoniae : Epidemiology of an Outbreak of Apparent Index Case Origin

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