Outbreak of Extended Spectrum Beta Lactamase Producing Klebsiella Species Causing Neonatal Sepsis at Patan Hospital in Nepal

  • Puja Amatya Patan Academy of Health Sciences, Lalitpur, Nepal
  • Suchita Joshi Patan Academy of Health Sciences, Lalitpur, Nepal
  • Shrijana Shrestha Patan Academy of Health Sciences, Lalitpur, Nepal

Abstract

Introductions: Klebsiella sepsis is the most important nosocomial infection in neonates. The objectives of this study were to review an outbreak in a neonatal unit caused by Klebsiella species, to identify the source of the infections, and to identify infection control measures for eradication and prevention of these infections.
Methods: The case notes and investigation reports of all sepsis cases admitted in neonatal units of Patan hospital from July to December 2011 caused by Klebsiella species were retrospectively reviewed. The demographic profile, risk factors along with clinical features and management of sepsis were reviewed.
Results: Twenty three out of 37 neonatal blood cultures grew Klebsiella species. Thirty one were K. pneumoniae and six K. oxytoca. Seventeen of the 31 (55%) K. pneumoniae isolates were multidrug resistant and extended spectrum beta lactamase producers. Eighteen of 23 (78%) neonates with Klebsiella sepsis died. After extensive cleaning methods and identifying an intermittently leaking roof in one of the nurseries below a vescicovaginal fistula room of gynecological ward above, the infection outbreak was finally controlled.
Conclusions: Infections with extended spectrum beta lactamase producing Klebsiella spp. are a threat in neonatal units because of limited treatment options for these multidrug resistant organisms. Identification of the source and control of the outbreak can be a challenge.
Keywords: extended spectrum beta lacatamase, Klebsiella, multi drug resistant, neonates

Author Biographies

Puja Amatya, Patan Academy of Health Sciences, Lalitpur, Nepal
Lecturer, Department of Pediatrics, Patan Academy of Health Sciences, Lalitpur, Nepal
Suchita Joshi, Patan Academy of Health Sciences, Lalitpur, Nepal
Assistant Professor, Departent of Pediatrics, Patan Academy of Health Sciences, Lalitpur, Nepal
Shrijana Shrestha, Patan Academy of Health Sciences, Lalitpur, Nepal
Professor, Department of Pediatrics, Patan Academy of Health Sciences, Lalitpur, Nepal
Published
2014-07-04
Section
General Section - Original Articles