Colonisation by extended-spectrum beta-lactamase-producing Klebsiella spp. in a paediatric intensive care unit

Area of Science:

• Microbiology
• Infectious Diseases
• Public Health

Background:

• Bacterial colonization with extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp. is a growing concern in healthcare settings.
• Understanding the incidence and risk factors for ESBL-producing Klebsiella spp. colonization in pediatric intensive care units (PICUs) is crucial for infection control.

Purpose of the Study:

• To determine the incidence and identify risk factors for colonization with ESBL-producing Klebsiella spp. in children admitted to a PICU.
• To provide baseline data for improving infection control practices and guiding future research in similar settings.

Main Methods:

• A prospective cohort study was conducted in a PICU in Recife, Brazil, over five months in 2008.
• Rectal swabs were collected from 186 children upon admission and on days 2, 5, 7, and 14.
• ESBL-producing Klebsiella spp. were identified using Kirby-Bauer disc diffusion and double disc synergy testing.

Main Results:

• The overall colonization rate with ESBL-producing Klebsiella spp. was 14%, with 7% of children colonized at admission.
• The incidence density of colonization during PICU stay was 14.2 per 1000 patient-days.
• Multivariable analysis identified the use of third-generation cephalosporins as a significant risk factor (P=0.008).
• Survival analysis indicated an increased risk of colonization with longer PICU stays.

Conclusions:

• The study highlights the prevalence of ESBL-producing Klebsiella spp. colonization in a Brazilian PICU.
• Third-generation cephalosporin use and prolonged length of stay are identified as key risk factors.
• Findings underscore the need for enhanced infection control strategies to mitigate cross-infection risks.