Background: In this study, we evaluated the genetic relatedness of extended-spectrum beta-lactamase-producing\nKlebsiella pneumoniae (ESBL-KPN) isolates from an outbreak in a neonatal intensive care unit (NICU) in August 2017,\nWe implemented an active countermeasure to control this outbreak successfully.\nMethods: The incidence of healthcare-associated ESBL-KPN bacteremia was evaluated before and after initiating\nenhanced infection control (IC) practices in January 2018. Surveillance cultures were set up and monitored for\nneonates, medical personnel, and NICU environments. Molecular analyses, including pulse-field gel electrophoresis\n(PFGE), sequence typing, and ESBL genotyping, were performed for the isolated KPN strains.\nResults: After implementing the enhanced IC procedures, the healthcare-associated bacteremia rate decreased\nfrom 6.0 to 0.0 per 1000 patient-days. Samples from neonates (n = 11/15, 73.3%), medical personnel (n = 1/41, 2.4%),\nand medical devices and the environments (6/181, 3.3%) tested positive for ESBL-KPN in the surveillance cultures in\nDecember 2017. Active surveillance cultures revealed that 23 of 72 neonates who were screened (31.9%) were\ncolonized with ESBL-KPN between January and March 2018. All the isolates demonstrated closely related PFGE\npatterns and were identified as ST307 strain carrying the CTX-M-15 gene.\nConclusions: Contaminated NICU environments and medical devices, as well as transmission by medical personnel,\nappeared to be the source of the outbreak of ESBL-KPN infection. We employed an enhanced IC strategy during\nJanuaryâ??March 2018 and successfully controlled the clonal outbreak of CTX-M-15-positive KPN. ST307 has emerged\nas an important bacteremia-causing pathogen in the NICU and should be carefully monitored
Loading....