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Outbreak of amikacin-resistant Enterobacteriaceae in an intensive care nursery
Abstract:
An outbreak of amikacin-resistant Enterobacteriaceae (KES) occurred in the Intensive Care Nursery (ICN) of the Louisville General Hospital from January 1978 through March 1978. Epidemic disease and an increased colonization rate in newborn infants due to amikacin-resistant microorganisms has not been documented previously. Three of the 11 neonates died. The organisms isolated were resistant to amikacin and two experimental aminoglycosides, sissomicin and netilmicin. The outbreak was contained following institution of several control measures, including pharyngeal inoculation of an experimental strain of alpha streptococcus in four infants.
Insights
An outbreak of amikacin-resistant Enterobacteriaceae (KES) in a neonatal intensive care unit (ICN) led to infant deaths. Control measures, including alpha streptococcus inoculation, contained the epidemic.
Area of Science:
- Infectious Disease Epidemiology
- Neonatal Intensive Care
- Antimicrobial Resistance
Background:
- An outbreak of amikacin-resistant Enterobacteriaceae (KES) occurred in the Intensive Care Nursery (ICN) from January to March 1978.
- This represented a previously undocumented epidemic disease and increased colonization rate in newborn infants due to amikacin-resistant microorganisms.
Purpose of the Study:
- To document and analyze an outbreak of amikacin-resistant Enterobacteriaceae (KES) in a neonatal intensive care unit (ICN).
- To identify the characteristics of the resistant organisms and evaluate control measures implemented.
Main Methods:
- Retrospective analysis of an outbreak in a hospital's ICN.
- Isolation and susceptibility testing of bacterial organisms.
- Implementation and assessment of infection control measures.
Main Results:
- Eleven neonates were affected, with three fatalities.
- Isolated organisms demonstrated resistance to amikacin and experimental aminoglycosides (sissomicin, netilmicin).
- Control measures, including pharyngeal inoculation with alpha streptococcus, were instituted.
Conclusions:
- The outbreak of amikacin-resistant Enterobacteriaceae (KES) in the ICN posed a significant threat to neonates.
- Effective control measures were crucial in containing the epidemic and preventing further spread.