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[Gentamycin resistant Enterobacteriaceae at a neonatal care unit]
T Balslev1, B Kristensen, F Ebbesen
1Aalborg Sygehus, paediatrisk afdeling, Statens Seruminstitut, København.
Insights
A neonatal unit outbreak of gentamicin-resistant Enterobacter cloacae was controlled using cohort nursing and reduced aminoglycoside use. This highlights the effectiveness of infection control strategies against resistant bacteria in newborns.
Area of Science:
- Neonatal infections
- Microbiology
- Epidemiology
Context:
- A case of infant septicaemia caused by gentamicin-resistant Enterobacter cloacae occurred in a neonatal unit.
- An epidemiological survey identified 18 additional asymptomatic patients colonized with gentamicin-resistant Enterobacteriaceae.
Purpose:
- To investigate the outbreak of gentamicin-resistant Enterobacter cloacae in a neonatal unit.
- To implement and evaluate control measures against the spread of resistant bacteria.
Summary:
- The outbreak was successfully controlled through cohort nursing, enhanced hygiene protocols, and a 50% reduction in aminoglycoside antibiotic consumption.
- Monitoring via weekly fecal samples confirmed the efficacy of the implemented control measures.
- All resistant strains identified possessed the aminoglycoside modifying enzyme AAC(3)II, with resistance being plasmid-mediated.
Impact:
- Demonstrates successful control of a multidrug-resistant bacterial outbreak in a vulnerable neonatal population.
- Provides evidence for the effectiveness of combined infection control strategies, including antibiotic stewardship, in neonatal intensive care units.
- Highlights the importance of molecular surveillance (plasmid-mediated resistance, enzyme identification) in understanding and managing antimicrobial resistance.
Abstract:
A case of septicaemia in a seven-day-old infant with a gentamicin-resistant strain of Enterobacter cloacae prompted an epidemiological survey in a neonatal unit. Another 18 patients harboured gentamicin-resistant Enterobacteriaceae without symptoms. Control of the outbreak was achieved by cohort nursing, strict hygiene and reduction of aminoglycoside consumption by 50%. Efficiency of the measures was monitored by weekly faecal samples from all patients. All strains produced the aminoglycoside modifying enzyme AAC(3)II. The resistance was plasmid-mediated.