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[Nosocomial infections with resistant Enterobacter cloacae. Effects on the disease and the treatment]
Abstract:
We describe five patients with serious nosocomial infection caused by resistant Enterobacter cloacae. Four of the patients underwent cardiovascular operations and were infected with an identical, multiple beta-lactam resistant E cloacae strain. The fifth patient was admitted with several wounds and skin-ulcers containing both resistant and sensitive E cloacae of other types. The resistant strain caused septicemia in four patients; three developed multiorgan failure and one died. The most probable causes of these infections were an abundant and constant reservoir of E cloacae in a sink at the operating unit, periodical breakdown of barriere routines, and heavy use of cephalosporins.
Insights
Serious nosocomial infections caused by multidrug-resistant Enterobacter cloacae occurred in five patients. Healthcare-associated infections were linked to contaminated sinks and breaches in sterile protocols.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Antimicrobial Resistance
Background:
- Nosocomial infections pose a significant threat in healthcare settings.
- Enterobacter cloacae is an opportunistic pathogen frequently implicated in hospital-acquired infections.
- The rise of multidrug-resistant organisms necessitates understanding transmission routes.
Observation:
- Five patients developed serious nosocomial infections due to resistant Enterobacter cloacae.
- Four patients undergoing cardiovascular operations were infected with an identical, multidrug-resistant strain.
- A fifth patient with wounds had both resistant and sensitive E. cloacae strains.
Findings:
- The resistant E. cloacae strain led to septicemia in four patients.
- Three patients experienced multiorgan failure, and one patient died.
- Probable sources include a contaminated sink in the operating unit, compromised barrier routines, and extensive cephalosporin use.
Implications:
- Highlights the critical need for stringent infection control measures in operating rooms.
- Emphasizes the role of environmental reservoirs in the spread of resistant bacteria.
- Underscores the impact of antibiotic stewardship on preventing multidrug-resistant organism outbreaks.