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An outbreak of gentamicin-resistant Enterobacter cloacae infections in a pediatric intensive care unit
Insights
A 1978 gentamicin-resistant Enterobacter cloacae outbreak in a pediatric intensive care unit primarily affected neonates. Premature and low-birth-weight newborns were most vulnerable to infection and bacteremia.
Area of Science:
- Infectious Diseases
- Neonatal Care
- Hospital Epidemiology
Background:
- Pediatric intensive care units (PICUs) are susceptible to nosocomial infections.
- Newborn infants in PICUs represent a high-risk population for healthcare-associated infections.
- Antibiotic resistance is a growing concern in hospital settings.
Purpose of the Study:
- To investigate an outbreak of gentamicin-resistant Enterobacter cloacae infections.
- To identify risk factors associated with infection and bacteremia in a pediatric intensive care unit.
- To highlight the vulnerability of neonates to nosocomial pathogens.
Main Methods:
- Retrospective analysis of patient data during an infection outbreak.
- Comparison of infected neonates with control groups.
- Identification of causative agent and its resistance profile.
Main Results:
- An outbreak involved 34 patients, with 30 being neonates.
- Six patients developed bacteremia, five of whom were neonates.
- Infected neonates were significantly smaller (<1500 g) and more premature (<35 weeks).
- Neonates with bacteremia had a higher incidence of congenital anomalies.
Conclusions:
- Neonates, particularly those who are premature and have congenital anomalies, are at high risk for nosocomial infections in PICUs.
- Gentamicin-resistant Enterobacter cloacae poses a significant threat to vulnerable infant populations.
- Effective infection control measures are crucial in pediatric intensive care settings.
Abstract:
The intensive care unit at Children's Medical Center in Dallas is a medical-surgical unit that cares for pediatric patients of all ages. In 1978 an outbreak of infections occurred that was caused by a gentamicin-resistant strain of Enterobacter cloacae. Thirty of the 34 patients involved in the outbreak were neonates. Six patients developed bacteremia, five of them neonates. The neonates who became infected were significantly smaller (less 1500 g) and more premature (less than 35 weeks) than control patients. Neonates with bacteremia had a significantly higher incidence of congenital anomalies. In a multi-specialty pediatric intensive care unit newborn infants were the group of patients at high risk for nosocomial infection.