Document Detail

Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails.
MedLine Citation:
PMID:  15061412     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: From April to June 2001, an outbreak of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae infections was investigated in our neonatal intensive care unit. METHODS: Cultures of the gastrointestinal tracts of patients, the hands of healthcare workers (HCWs), and the environment were performed to detect potential reservoirs for ESBL-producing K. pneumoniae. Strains of K. pneumoniae were typed by pulsed-field gel electrophoresis using XbaI. A case-control study was performed to determine risk factors for acquisition of the outbreak clone (clone A); cases were infants infected or colonized with clone A and controls (3 per case) were infants with negative surveillance cultures. RESULTS: During the study period, 19 case-infants, of whom 13 were detected by surveillance cultures, harbored clone A. The overall attack rate for the outbreak strain was 45%; 9 of 19 infants presented with invasive disease (n = 6) or developed invasive disease (n = 3) after colonization was detected. Clone A was found on the hands of 2 HCWs, 1 of whom wore artificial nails, and on the designated stethoscope of a case-infant. Multiple logistic regression analysis revealed that length of stay per day (odds ratio [OR], 1.05; 95% confidence interval [CI95], 1.02 to 1.09) and exposure to the HCW wearing artificial fingernails (OR, 7.87; CI95, 1.75 to 35.36) were associated with infection or colonization with clone A. CONCLUSION: Short, well-groomed, natural nails should be mandatory for HCWs with direct patient contact
Archana Gupta; Phyllis Della-Latta; Betsy Todd; Pablo San Gabriel; Janet Haas; Fann Wu; David Rubenstein; Lisa Saiman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America     Volume:  25     ISSN:  0899-823X     ISO Abbreviation:  Infect Control Hosp Epidemiol     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-04-05     Completed Date:  2004-05-13     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8804099     Medline TA:  Infect Control Hosp Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  210-5     Citation Subset:  IM; N    
Department of Pediatrics, Columbia University, New York-Presbyterian Hospital, New York, New York 10032, USA.
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MeSH Terms
Case-Control Studies
Cross Infection / epidemiology,  microbiology*,  transmission*
Disease Outbreaks* / prevention & control
Disease Reservoirs
Electrophoresis, Gel, Pulsed-Field
Hand / microbiology
Infant, Newborn
Infection Control
Infectious Disease Transmission, Professional-to-Patient
Intensive Care Units, Neonatal*
Klebsiella Infections / epidemiology*,  prevention & control
Klebsiella pneumoniae / enzymology,  isolation & purification*
Logistic Models
Nails / microbiology*
New York City / epidemiology
Nursing Staff, Hospital
Risk Factors
beta-Lactamases / metabolism*
Reg. No./Substance:

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