An Outbreak of Gentamicin-Resistant Klebsiella pneumoniae: Analysis of Control Measures
In April 1978, a strain of gentamicin-resistant Klebsiella pneumoniae (GRK) was introduced into the neonatal intensive care unit of Henry Ford Hospital. An additional ten cases of GRK occurred over the subsequent 16 months and intestinal colonization occurred in up to 91% of admissions per month. Al...
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| Veröffentlicht in: | Infection control : IC 1984-02, Vol.5 (2), p.79-84 |
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| container_title | Infection control : IC |
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| creator | Saravolatz, Louis D. Arking, Lucille Pohlod, Donald Fisher, Evelyn J. Borer, Robert |
| description | In April 1978, a strain of gentamicin-resistant Klebsiella pneumoniae (GRK) was introduced into the neonatal intensive care unit of Henry Ford Hospital. An additional ten cases of GRK occurred over the subsequent 16 months and intestinal colonization occurred in up to 91% of admissions per month. All GRK were susceptible to amikacin and were capsular serotype 19. Though hand contamination of hospital personnel with GRK was documented, increased handwashing practices did not reduce colonization rates of neonates with the epidemic strain. Intestinal carriage persisted for up to ten months and could not be eradicated by administering oral colistin sulfate. Discontinuation of gentamicin and utilization of amikacin were associated with a significant reduction in colonization with GRK (p |
| doi_str_mv | 10.1017/S0195941700058999 |
| format | Article |
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An additional ten cases of GRK occurred over the subsequent 16 months and intestinal colonization occurred in up to 91% of admissions per month. All GRK were susceptible to amikacin and were capsular serotype 19. Though hand contamination of hospital personnel with GRK was documented, increased handwashing practices did not reduce colonization rates of neonates with the epidemic strain. Intestinal carriage persisted for up to ten months and could not be eradicated by administering oral colistin sulfate. Discontinuation of gentamicin and utilization of amikacin were associated with a significant reduction in colonization with GRK (p<0.05). 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An additional ten cases of GRK occurred over the subsequent 16 months and intestinal colonization occurred in up to 91% of admissions per month. All GRK were susceptible to amikacin and were capsular serotype 19. Though hand contamination of hospital personnel with GRK was documented, increased handwashing practices did not reduce colonization rates of neonates with the epidemic strain. Intestinal carriage persisted for up to ten months and could not be eradicated by administering oral colistin sulfate. Discontinuation of gentamicin and utilization of amikacin were associated with a significant reduction in colonization with GRK (p<0.05). However, the only control measure that prevented both new cases and colonization with the epidemic strain was the utilization of a strict cohort system.</description><subject>Antimicrobials</subject><subject>Carrier State - epidemiology</subject><subject>Carrier State - prevention & control</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - prevention & control</subject><subject>Disease Outbreaks - epidemiology</subject><subject>Disease Outbreaks - prevention & control</subject><subject>Drug Resistance, Microbial</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Gentamicins - therapeutic use</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Infections</subject><subject>Intensive Care Units, Neonatal</subject><subject>Klebsiella</subject><subject>Klebsiella Infections - epidemiology</subject><subject>Klebsiella Infections - prevention & control</subject><subject>Klebsiella pneumoniae - drug effects</subject><subject>Michigan</subject><subject>Microbial colonization</subject><subject>Neonatal intensive care units</subject><subject>Newborns</subject><subject>Nursing</subject><subject>Teaching hospitals</subject><issn>0195-9417</issn><issn>2327-9451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1984</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkDtPwzAUhS0EKqXwAxiQMrEF_IxttqqCgiiqxEOMke3eSCmJXexk6L-nEVUZmO7wne_o6iB0SfANwUTevmGiheZEYoyF0lofoTFlVOaaC3KMxgPOB36KzlJaY8wLScUIjQpWCEX0GH1OfbbsOxvBfGWhyubgO9PWrvb5K6Q6dcZ32XMDNtXQNCbbeOjb4GsDd9nUm2a7ywzeLPguhiZ7AZP6COkcnVSmSXCxvxP08XD_PnvMF8v502y6yB0jqssp51LxAqhwasUMVdo6wyhjFDsQjNmKEgzYMiUtCKwqIQpGKyI4VFYSxybo-rd3E8N3D6kr2zq54VUPoU-lwrooOJO7IPkNuhhSilCVm1i3Jm5LgsthzPLfmDvnal_e2xZWB2O_3h9fpy7EA2aYcFoQwX4AINF4Vg</recordid><startdate>198402</startdate><enddate>198402</enddate><creator>Saravolatz, Louis D.</creator><creator>Arking, Lucille</creator><creator>Pohlod, Donald</creator><creator>Fisher, Evelyn J.</creator><creator>Borer, Robert</creator><general>SLACK Incorporated</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198402</creationdate><title>An Outbreak of Gentamicin-Resistant Klebsiella pneumoniae: Analysis of Control Measures</title><author>Saravolatz, Louis D. ; Arking, Lucille ; Pohlod, Donald ; Fisher, Evelyn J. ; Borer, Robert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c318t-2447846e25c8d3a289bca323320ce533bf210e0b387be508f55632f154efb71c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1984</creationdate><topic>Antimicrobials</topic><topic>Carrier State - epidemiology</topic><topic>Carrier State - prevention & control</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - prevention & control</topic><topic>Disease Outbreaks - epidemiology</topic><topic>Disease Outbreaks - prevention & control</topic><topic>Drug Resistance, Microbial</topic><topic>Epidemics</topic><topic>Epidemiology</topic><topic>Gentamicins - therapeutic use</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Infections</topic><topic>Intensive Care Units, Neonatal</topic><topic>Klebsiella</topic><topic>Klebsiella Infections - epidemiology</topic><topic>Klebsiella Infections - prevention & control</topic><topic>Klebsiella pneumoniae - drug effects</topic><topic>Michigan</topic><topic>Microbial colonization</topic><topic>Neonatal intensive care units</topic><topic>Newborns</topic><topic>Nursing</topic><topic>Teaching hospitals</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saravolatz, Louis D.</creatorcontrib><creatorcontrib>Arking, Lucille</creatorcontrib><creatorcontrib>Pohlod, Donald</creatorcontrib><creatorcontrib>Fisher, Evelyn J.</creatorcontrib><creatorcontrib>Borer, Robert</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Infection control : IC</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saravolatz, Louis D.</au><au>Arking, Lucille</au><au>Pohlod, Donald</au><au>Fisher, Evelyn J.</au><au>Borer, Robert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An Outbreak of Gentamicin-Resistant Klebsiella pneumoniae: Analysis of Control Measures</atitle><jtitle>Infection control : IC</jtitle><addtitle>Infect Control</addtitle><date>1984-02</date><risdate>1984</risdate><volume>5</volume><issue>2</issue><spage>79</spage><epage>84</epage><pages>79-84</pages><issn>0195-9417</issn><eissn>2327-9451</eissn><abstract>In April 1978, a strain of gentamicin-resistant Klebsiella pneumoniae (GRK) was introduced into the neonatal intensive care unit of Henry Ford Hospital. An additional ten cases of GRK occurred over the subsequent 16 months and intestinal colonization occurred in up to 91% of admissions per month. All GRK were susceptible to amikacin and were capsular serotype 19. Though hand contamination of hospital personnel with GRK was documented, increased handwashing practices did not reduce colonization rates of neonates with the epidemic strain. Intestinal carriage persisted for up to ten months and could not be eradicated by administering oral colistin sulfate. Discontinuation of gentamicin and utilization of amikacin were associated with a significant reduction in colonization with GRK (p<0.05). However, the only control measure that prevented both new cases and colonization with the epidemic strain was the utilization of a strict cohort system.</abstract><cop>United States</cop><pub>SLACK Incorporated</pub><pmid>6365819</pmid><doi>10.1017/S0195941700058999</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-9417 |
| ispartof | Infection control : IC, 1984-02, Vol.5 (2), p.79-84 |
| issn | 0195-9417 2327-9451 |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Antimicrobials Carrier State - epidemiology Carrier State - prevention & control Cross Infection - epidemiology Cross Infection - prevention & control Disease Outbreaks - epidemiology Disease Outbreaks - prevention & control Drug Resistance, Microbial Epidemics Epidemiology Gentamicins - therapeutic use Humans Infant, Newborn Infants Infections Intensive Care Units, Neonatal Klebsiella Klebsiella Infections - epidemiology Klebsiella Infections - prevention & control Klebsiella pneumoniae - drug effects Michigan Microbial colonization Neonatal intensive care units Newborns Nursing Teaching hospitals |
| title | An Outbreak of Gentamicin-Resistant Klebsiella pneumoniae: Analysis of Control Measures |
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