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Molecular-epidemiologic study on outbreak of colonization by extended spectrum beta-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit / 소아과
Korean Journal of Pediatrics ; : 150-156, 2006.
Article in Korean | WPRIM | ID: wpr-180577
ABSTRACT

PURPOSE:

The aims of this study included assessment of molecular-epidemiologic features during an outbreak of colonization of extended spectrum beta-lactamase producing Klebsiella pneumoniae(ESBL-KPN) and re-evaluation of their colonized status one year later.

METHODS:

Rectal swab cultures for ESBL-KPN from all hospitalized infants and newly admitted infants were obtained during the outbreak of colonization from July to December, 2000. The pattern of XbaI-digested chromosomal DNA of isolates were analyzed by pulsed-field gel electrophoresis. Weekly rectal swab cultures were obtained during the outbreak until patients were either discharged or decolonized. Patients discharged after being colonized had follow up stool cultures a year later.

RESULTS:

A total of 80 patients(28.5 percent) were colonized. Of those, 53 whose pulsed-field gel electrophoresis(PFGE) was possible only once, were ESBL-KPN grouped into six cluster clones and 10 single clones28 patients(52.8 percent) were colonized with type A, the most common clone, followed by type B in 11 patients(20.8 percent). Of those 12 patients in whom serial PFGE was done more than twice, type A was predominant. Narrowed-down in strains occurred from types A, B, C, D and three single clones at initiation of the study into types A and type B after three months of strict infection control. Among 75 patients(93.7 percent) who were sent home after being colonized, 30 patients were re-called for stool cultures a year laterAll of them were decolonized.

CONCLUSION:

This study demonstrates the importance of infection control as the diversity of ESBL-KPN strains could be narrowed into fewer strains. Colonization of ESBL-KPN could be reversed upon return to the community.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Beta-Lactamases / DNA / Intensive Care, Neonatal / Follow-Up Studies / Infection Control / Electrophoresis, Gel, Pulsed-Field / Clone Cells / Colon / Klebsiella / Klebsiella pneumoniae Type of study: Observational study / Prognostic study Limits: Humans / Infant / Infant, Newborn Language: Korean Journal: Korean Journal of Pediatrics Year: 2006 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Beta-Lactamases / DNA / Intensive Care, Neonatal / Follow-Up Studies / Infection Control / Electrophoresis, Gel, Pulsed-Field / Clone Cells / Colon / Klebsiella / Klebsiella pneumoniae Type of study: Observational study / Prognostic study Limits: Humans / Infant / Infant, Newborn Language: Korean Journal: Korean Journal of Pediatrics Year: 2006 Type: Article