Document Detail

Outbreak of late-onset group B Streptococcus in a neonatal intensive care unit.
MedLine Citation:
PMID:  20022407     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In September 2007, the Tennessee Department of Health was notified of a cluster of late-onset group B streptococcal (GBS) infections in a neonatal intensive care unit (NICU). Outbreaks of late-onset GBS are rare. METHODS: A case was defined as culture-confirmed invasive GBS infection in a neonate aged > or =7 days, identified in hospital A during August 23 to September 6, 2007. We reviewed medical records; examined NICU microbiology reports; and performed serotyping, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) on invasive isolates. Maternal GBS screening, prophylaxis, and infection control policies were reviewed and staff practices observed. RESULTS: Five cases of late-onset GBS were identified. None of the mothers of the infants received optimal GBS prophylaxis. Patient isolates were of 2 serotypes, 3 PFGE patterns, and 2 MLST patterns. Three isolates were indistinguishable on subtyping. These 3 cases were clustered in time. No common health care providers were identified. Infection control deviations in the NICU were observed. CONCLUSION: We identified a multiclonal cluster of 5 late-onset GBS cases. Multiple factors likely contributed to the outbreak, including nosocomial transmission of GBS. Further efforts to prevent late-onset GBS disease are necessary.
Jennifer K MacFarquhar; Timothy F Jones; Amy M Woron; Marion A Kainer; Cynthia G Whitney; Bernard Beall; Stephanie J Schrag; William Schaffner
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Publication Detail:
Type:  Journal Article     Date:  2009-12-22
Journal Detail:
Title:  American journal of infection control     Volume:  38     ISSN:  1527-3296     ISO Abbreviation:  Am J Infect Control     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-27     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8004854     Medline TA:  Am J Infect Control     Country:  United States    
Other Details:
Languages:  eng     Pagination:  283-8     Citation Subset:  IM    
Copyright Information:
Published by Mosby, Inc.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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MeSH Terms
Bacterial Typing Techniques
Cross Infection / epidemiology*,  microbiology
DNA Fingerprinting
Disease Outbreaks*
Electrophoresis, Gel, Pulsed-Field
Infant, Newborn
Intensive Care Units, Neonatal
Sequence Analysis, DNA
Streptococcal Infections / epidemiology*,  microbiology
Streptococcus agalactiae / classification,  genetics,  immunology,  isolation & purification*
Tennessee / epidemiology

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