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Korean J healthc assoc Infect Control Prev 2013; 18(1): 26-32

Published online June 30, 2013 https://doi.org/10.14192/kjnic.2013.18.1.26

Copyright © Korean Society for Healthcare-associated infection Control and Prevention

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Successful Control of Extended-spectrum Beta-lactamase-producing Klebsiella pneumoniae Outbreak in a Neonatal Intensive Care Unit

Mi Ja Kim1, Kil Soo Chung2, Kyung Mok Sohn3

Department of Nursing, Pai Chai University1, Daejeon, Department of Nursing, Kyung-in Women's College2, Incheon, Division of Infections Disease, Chungnam National University Hospital3, Daejeon, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Extended-spectrum beta-lactamase-producing (ESBL) Klebsiella pneumoniae is an important cause of nosocomial infections in neonatal intensive care units (NICUs). This study aimed to reduce ESBL-producing K. pneumoniae in the NICU by using infection control measures.

Methods: We performed prospective surveillance cultures, monitoring, and education for infection control in the NICU between May and August 2011. Specimens were collected from all infants and the environment including stethoscopes, thermometers, ventilators, incubators, etc. The anterior nares and hands of healthcare workers were also screened. We inspected infection control practices and provided feedback. The level of infection control awareness was measured using a questionnaire.

Results: The level of awareness and performance of hand washing increased significantly after intervention (both P<0.001). The environmental management of healthcare providers also improved significantly (P=0.001). The yield of ESBL-producing K. pneumoniae from clinical specimens decreased gradually throughout the study period (30.4% in May to 12.6% in August). Central catheter-related K. pneumoniae bacteremia decreased from 1.3/1000 to 0/1000 catheter-days.

Conclusion: Infection control measures including education, monitoring, and surveillance can lower the incidence of ESBL-producing K. pneumoniae in the NICU.

Keywords: Beta-Lactamases, Infant, Intensive care units, Klebsiella pneumoniae, Newborn

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