Factors related to the monitoring and elimination of an outbreak of carbapenemase-producing Klebsiella pneumoniae in the neo-natology unit of the Metropolitan Hospital of Quito Original Research

Abstract

Introduction: Nosocomial infections are a burden for the healthcare system. This study reports the observational data from an outbreak of Klebsiella pneumoniae in a neonatology unit and measures taken following identification.

Methods: We used a descriptive, observational, ambispective design to study nosocomial infections. Strict barrier measures were implemented with checklists and surveillance cameras in the Neonatology Unit. The observations were reported and analyzed using descriptive statistics.

Results: Six cases were diagnosed with Klebsiella pneumoniae; all were premature newborn patients, three of them extreme. Four patients had early sepsis. The culture samples included three blood cultures, two urine cultures, and one culture of pharyngeal secretion. Along with the Klebsiella pneumoniae culture, other pathogens were identified. The coinfection of Klebsiella with S. aureus lasted longer in isolation compared with Klebsiella alone. Among the cultures, two were positive for extended-spectrum beta-lactamases (ESBL) producing Klebsiella pneumoniae, and four were positive for multi-sensitive Klebsiella pneumoniae. After intervention, there were no new cases during the 12 months following the outbreak.

Conclusions: After the outbreak of six cases of Klebsiella pneumoniae in the neonatology unit, strict biosafety measures were established, in which compliance was registered on checklists and monitored by security cameras. The elimination of nosocomial infections was achieved in a control period after 12 months following the interventions.