Outbreak of Extended-Spectrum Beta-Lactamase–ProducingKlebsiella Pneumoniaein a Neonatal Intensive Care Unit Linked to Artificial Nails

Abstract

Short, well-groomed, natural nails should be mandatory for HCWs with direct patient contact

Risk factors for late-onset health care–associated bloodstream infections in patients in neonatal intensive care units

“…Notably, NICU 1 had significantly more neonates with low birth weight, performed more surgical procedures, used more NC-CPAP, was more crowded, and experienced outbreaks of Klebsiella pneumoniae and Staphylococcus epidermidis. 15,16 This study was also large enough to allow us to examine risk factors for BSI (after controlling for birth weight) among subgroups of neonates, such as infants with central venous catheters, those with non-CR BSI, and those with BSI caused by gram-positive versus gram-negative organisms. Such subgroup analyses provide more precise estimates of risk, which can be used to guide clinical practice.…”

Multicenter Study of Hand Carriage of Potential Pathogens by Neonatal ICU Healthcare Personnel: Table 1.

“…In addition, several studies of HCP hand carriage have been performed during outbreaks in efforts to detect a potential point source. Outbreaks of Pseudomonas aeruginosa [5,6], extended spectrum β-lactamase-producing Klebsiella pneumoniae [7], and Serratia marcescens [8] have been linked to artificial nails worn by HCP, and molecular epidemiology has confirmed transmission to infants. However, all 4 sites in this current study banned HCP from wearing artificial nails.…”

Hand Hygiene

“…159,167,977 In a recent study, multiple logistic regression analysis showed the association of an outbreak of extended-spectrum beta-lactamase-producing K. pneumoniae in a neonatal ICU resulting from exposure to an HCW wearing artificial fingernails. 155 A cluster of five cases of S. marcescens bacteraemia in haemodialysis was associated with a nurse who used an artificial fingernail to open a vial of heparin that was mixed to make a flush solution. The strains isolated from the five patients and the nurse were indistinguishable.…”