RICHARDS CL, ALONSO-ECHANOVE J, CAICEDO Y, JARVIS WR; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 653 (abstract no. 2088).
Hosp. Infections ProgramCDC, Atlanta, GA
BACKGROUND: Klebsiella pneumoniae (KP) is an infrequent cause of bloodstream infection (BSI) in high-risk nursery (HRN) patients. From February 6 to March 8, 1999, nine patients with KP-BSI resulting in three deaths were identified in a HRN and an investigation was initiated.METHODS: To determine risk factors for KP-BSIs, we conducted a retrospective cohort study of patients hospitalized in the HRN from February 6 to March 8, 1999 (study period). A case-patient was defined as any Hospital Universitario Del Valle HRN patient with symptomatic KP-BSI during the study period. A colonized patient was defined as any HRN patient with positive cultures for KP from non-sterile sites. To assess the prevalence of KP colonization, we conducted three prevalence surveys (March 19, March 27, and April 8, 1999) of all HRN neonates.RESULTS: Of 105 patients, we identified 9 case- and 24 colonized patients. Case-patients presented with fever or hypothermia (8/ 9), hypotension (4/9), tachypnea (4/9), tachycardia (4/9), apnea (3/9), or bradycardia (2/9). Compared to colonized patients, case-patients had lower median gestational age (28 vs 33.5 weeks, p=0.04), were more likely to have an umbilical catheter (70% vs 36%, p=0.07), and received more blood transfusions (2.3 vs 0.8, p=0.02). The prevalence of HRN patients colonized with KP was 46% (19/41). One week after cohorting all KP colonized or infected patients, the prevalence of KP colonization was reduced to 26% (11/43; p=0.04). Since cohorting of KP colonized patients was initiated (March 21 to April 28, 1999), only one neonate has developed KP-BSI.CONCLUSIONS: We identified a large reservoir of KP-colonized neonates in this HRN. Low gestational age, use of umbilical catheters, and number of blood transfusions were as sociated with BSI. Cohorting neonates was effective in reducing the prevalence of KP colonized and infected patients.
Publication Types:
Keywords:
- Cohort Studies
- Colombia
- Humans
- Infant, Newborn
- Klebsiella Infections
- Klebsiella pneumoniae
- Nurseries
- Nurseries, Hospital
- Prevalence
- Retrospective Studies
- Risk Factors
- blood supply
Other ID:
UI: 102246178
From Meeting Abstracts