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A hospital epidemic caused by a gentamicin-resistant Klebsiella aerogenes

Published online by Cambridge University Press:  15 May 2009

Kathleen Curie ,
D. C. E. Speller ,
Rosemary A. Simpson ,
Mary Stephens  and
P. I. Cooke
Kathleen Curie
Affiliation:
Bristol Royal Infirmary, Bristol BS2 8HW
D. C. E. Speller
Affiliation:
Bristol Royal Infirmary, Bristol BS2 8HW
Rosemary A. Simpson
Affiliation:
Bristol Royal Infirmary, Bristol BS2 8HW
Mary Stephens
Affiliation:
Bristol Royal Infirmary, Bristol BS2 8HW
P. I. Cooke
Affiliation:
Bristol Royal Infirmary, Bristol BS2 8HW
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Summary

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In the 15 months, February 1976 to April 1977, more than 241 patients became colonized with a strain of Klebsiella aerogenes, capsular serotype K2, resistant to most antibiotics. Urinary tract infection was the most common clinical manifestation but bacteraemia and, occasionally, infections of other sites were encountered. The main reservoir of the epidemic klebsiella was the gut, urine and skin of colonized patients. Gut carriage among staff was very uncommon. The most susceptible patients were elderly males, with debilitating illnesses and urinary tract abnormalities, especially if they were catheterized or receiving antibiotics. Likely vehicles for spread were the hands of staff, and contaminated bedpans and urinals. Control measures were directed at these factors. At the end of April 1977 no new cases had occurred for 3 months in the ward in which the outbreak began, and which had been the main focus of infection, and only 5 patients in the affected hospitals were known to be colonized by the epidemic klebsiella.

Type
Research Article
Information
Journal of Hygiene , Volume 80 , Issue 1 , February 1978 , pp. 115 - 123
Copyright
Copyright © Cambridge University Press 1978

References

REFERENCES

Ayliffe, G. A. J., Collins, B. J. & Deverill, C. E. A. (1974). Tests of disinfection by heat in a bedpan washing machine. Journal of Clinical Pathology 27, 760.CrossRefGoogle Scholar
Coonrod, J. D. & Rytel, M. W. (1973). Detection of type-specific pneumococcal antigens by counterimmunoelectrophoresis: I. Methodology and immunologic properties of pneumoeoccal antigens. Journal of Laboratory and Clinical Medicine 81, 770.Google ScholarPubMed
Cowan, S. T. (1974). Cowan & Steel's Manual for the Identification of Medical Bacteria. Cambridge University Press.Google Scholar
Eickhoff, T. C. (1971). Nosocomial infections due to Klebsiella pneumoniae: mechanisms of intra-hospital spread. In Proceedings of the International Conference on Nosocomial Infections (1970), ed. Brachman, P. S. and Eickhoff, T. C., p. 117. Center for Disease Control, Atlanta.Google Scholar
Forbes, I., Gray, A., Hurse, A. & Pavillard, R. (1977). The emergence of gentamicinresistant klebsiellae in a large general hospital. Medical Journal of Australia 1, 14.CrossRefGoogle Scholar
Gibson, G. L. (1976). The bedpan and cross-infection. Nursing Times 1198.Google ScholarPubMed
Gillespie, W. A., Lennon, G. G., Linton, K. B. & Phippen, G. A. (1967). Prevention of urinary infection by means of closed drainage into a sterile plastic bag. British Medical Journal iii, 90.CrossRefGoogle Scholar
Kelsey, J. C. & Sykes, G. (1969). A new test for the assessment of disinfectants with particular reference to their use in hospitals. Pharmaceutical Journal 202, 607.Google Scholar
Maurer, I. (1969). A test for stability and long term effectiveness of disinfectants. Pharmaceutical Journal 203, 529.Google Scholar
Maurer, I. (1974). Hospital Hygiene. London Edward Arnold.Google Scholar
Noriega, E. R., Leibowitz, R. E., Richmond, A. S., Rubinstein, E., Shaefler, S., Simberkoff, M. S. & Rahal, J. J. (1975). Nosocomial infection caused by gentamicinresistant, streptomycin-sensitive klebsiella. Journal of Infectious Diseases 131 (supplement), S45.CrossRefGoogle ScholarPubMed
Price, D. J. E. & Sleigh, J. D. (1970). Control of infection due to Klebsiella aerogenes in a neurosurgical unit by withdrawal of all antibiotics. Lancet ii, 1213.CrossRefGoogle Scholar
Price, P. B. (1938). The bacteriology of normal skin; a new quantitative test applied to a study of the bacterial flora and the disinfectant action of mechanical cleansing. Journal of Infectious Diseases 63, 301.CrossRefGoogle Scholar
Rennie, R. P. & Duncan, I. B. R. (1977). Emergence of gentamicin-resistant Klebsiella in a general hospital. Antimicrobial Agents and Chemotherapy 11, 179.CrossRefGoogle ScholarPubMed
Salzman, T. C., Clark, J. J. & Klemm, L. (1968). Hand contamination of personnel as a mechanism of cross-infection in nosocomial infections with antibiotic-resistant E. coli and klebsiella-aerobacter. Antimicrobial Agents and Chemotherapy 7, 97.Google Scholar
Schaberg, D. R., Weinstein, R. A. & Stamm, W. E. (1976). Epidemics of nosocomial urinary tract infection caused by multiply resistant gram-negative bacilli: epidemiology and control. Journal of Infectious Diseases 133, 363.CrossRefGoogle ScholarPubMed
Selden, R., Lee, S., Wang, W. L. L., Bennett, J. V. & Eickhoff, T. C. (1971). Nosocomial klebsiella infections: intestinal colonisation as a reservoir. Annals of Internal Medicine 74, 657.CrossRefGoogle ScholarPubMed
Speller, D. C. E., Bint, A. J. & Stephens, M. (1977). Experience with amikacin and colistin in an outbreak of infection by resistant Klebsiella aerogenes. Journal of Antimicrobial Chemotherapy 3, 483.CrossRefGoogle Scholar
Speller, D. C. E., Raghunath, D., Stephens, M., Viant, A. C., Reeves, B. S., Wilkinson, P. J., Broughall, J. M. & Holt, H. A. (1976). Epidemic infection by a gentamicin-resistant Staphylococcus aureus in three hospitals. Lancet i, 464.CrossRefGoogle Scholar