Outbreak of <i>Enterobacter cloacae</i> Related to Understaffing, Overcrowding, and Poor Hygiene Practices

Eckmanns, Tim; Rath, Andrea; Rüden, H.; Gastmeier, Petra; Daschner, F

doi:10.1086/503226

Cited by 17 publications

(7 citation statements)

References 4 publications

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“…Higher average compliance with hand antisepsis and hand washing procedures was found in an observational study in 8 KISS ICUs (61%). 10 The 25.7% overall reduction for all of the participating ICUs was not as great as the recently reported decrease among ICUs in the National Nosocomial Infections Surveillance System (from 31% to 44%, depending on the type of ICU); however, the latter were monitored during a longer period (9 years). 11 It is difficult to evaluate decreases in pooled data.…”

Section: Discussionmentioning

confidence: 70%

Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

Zuschneid

Schwab

Geffers

et al. 2003

Infect. Control Hosp. Epidemiol.

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Section: Discussionmentioning

confidence: 70%

Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

Zuschneid

Schwab

Geffers

et al. 2003

Infect. Control Hosp. Epidemiol.

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“…Poor compliance noted in winter might have been due to workload, particularly since 'zero tolerance' was not advertised before or during the winter sessions. 16 Bed occupancy rates for the medical unit during the summer were 93e95%, whereas those for the winter were >97%. These rates are calculated according to occupancy in a bed at midnight.…”

Section: Discussionmentioning

confidence: 97%

Where do hands go? An audit of sequential hand-touch events on a hospital ward

Smith

Young

Robertson

et al. 2012

Journal of Hospital Infection

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“…(ii) Another important component in the success of the intervention was to reduce the workload and improve compliance with control measures. Overcrowding and understaffing could lead to the breakdown of control measures, which in turn facilitated the transmission, even if patients were placed in single rooms after knowing the carriage status of multi-drug resistant (MDR) bacteria [ 28 , 29 ]. One study also showed that patient/nurse ratio was associated with rectal CRKP colonization [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and clinical characteristics of infection/colonization due to carbapenemase-producing Enterobacterales in neonatal patients

Wang

Yang

et al. 2022

BMC Microbiol

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Background The aim of this study was to elucidate the epidemiological features of carbapenemase-producing Enterobacterales (CPE) in the pediatric and neonatal patients, to describe clinical characteristics of neonatal patients with CPE infections, and to assess risk factors for neonatal rectal colonization with CPE. Results A total of 439 carbapenem-resistant Enterobacterales (CRE) isolates recovered from 367 infant patients were characterised, including 397 isolates of Klebsiella pneumoniae (KP) and 42 isolates of Escherichia coli (EC). Carbapenemase gene blaNDM-1 was the most commonly detected, accounting for 86.56% (n = 380), followed by blaKPC-2 (9.11%, 40) and blaIMP-4 (4.33%, 19). MLST analysis showed 17 different STs detected within CPKP isolates, with ST20, ST2068, ST36 and ST17 being the most frequently isolated types. Eleven STs were identified within CPEC isolates, with ST325 being the dominant types. Eight isolates of NDM-1 producing KP, belonging to ST23, were identified as having hypervirulent traits. The main infections caused by CPE were pneumonia (n = 90) and sepsis (n = 16). All infected patients received monotherapy, with meropenem and ciprofloxacin being the most commonly used antibiotics. All pneumonia patients were cured or improved after treatment. Of the 16 patients with sepsis, 9 were cured or improved, 3 died, and 4 abandoned treatment without any clinical improvement. The rectal prevalences of CPE in the 0–3 days old (DO), the 4–28 DO, and the 29 DO-1 year old groups were decreased from 15.31%, 27.37% and 14.29% in the first stool screening period to 11.78%, 19.59% and 4.07% in the second stool screening period, respectively. Multivariate analysis showed that cesarean section, acidosis, respiration failure, gastric lavage and enema were independent risk factors for rectal colonization in the 0–3 DO group, whereas cesarean section, cephalosporins, gastric lavage and residence in rural area were independently associated with rectal colonization in the 4–28 DO group. The implementation of a series of evidence-based control measures eventually contained the CPE transmission. Conclusions Continued vigilance, epidemiological studies, and multimodal infection prevention strategies are urgently needed due to frequent importations.

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Outbreak of Enterobacter cloacae Related to Understaffing, Overcrowding, and Poor Hygiene Practices

Cited by 17 publications

References 4 publications

Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

Where do hands go? An audit of sequential hand-touch events on a hospital ward

Epidemiology and clinical characteristics of infection/colonization due to carbapenemase-producing Enterobacterales in neonatal patients

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