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An Outbreak of Gentamicin-Resistant Klebsiella pneumoniae: Analysis of Control Measures

Published online by Cambridge University Press:  02 January 2015

Louis D. Saravolatz ,
Lucille Arking ,
Donald Pohlod ,
Evelyn J. Fisher  and
Robert Borer
Louis D. Saravolatz*
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology and Division of Neonatology, Henry Ford Hospital, Detroit, Michigan University of Michigan Medical School, Detroit, Michigan
Lucille Arking
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology and Division of Neonatology, Henry Ford Hospital, Detroit, Michigan University of Michigan Medical School, Detroit, Michigan
Donald Pohlod
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology and Division of Neonatology, Henry Ford Hospital, Detroit, Michigan University of Michigan Medical School, Detroit, Michigan
Evelyn J. Fisher
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology and Division of Neonatology, Henry Ford Hospital, Detroit, Michigan University of Michigan Medical School, Detroit, Michigan
Robert Borer
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology and Division of Neonatology, Henry Ford Hospital, Detroit, Michigan University of Michigan Medical School, Detroit, Michigan
*
Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202
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Abstract

In April 1978, a strain of gentamicin-resistant Klebsiella pneumoniae (GRK) was introduced into the neonatal intensive care unit of Henry Ford Hospital. An additional ten cases of GRK occurred over the subsequent 16 months and intestinal colonization occurred in up to 91% of admissions per month. All GRK were susceptible to amikacin and were capsular serotype 19. Though hand contamination of hospital personnel with GRK was documented, increased handwashing practices did not reduce colonization rates of neonates with the epidemic strain. Intestinal carriage persisted for up to ten months and could not be eradicated by administering oral colistin sulfate. Discontinuation of gentamicin and utilization of amikacin were associated with a significant reduction in colonization with GRK (p < 0.05). However, the only control measure that prevented both new cases and colonization with the epidemic strain was the utilization of a strict cohort system.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 2 , February 1984 , pp. 79 - 84
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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