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A Nursery Outbreak of Multiple-Aminoglycoside-Resistant Escherichia coli

Published online by Cambridge University Press:  02 January 2015

Robert R Gaynes*
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
Diane Simpson
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
Sally A. Reeves
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
Robert C. Noble
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
Clyde Thornsberry
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
David Culver
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
James R. Allen
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
William J. Martone
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia; the Department of Infection Control and the Department of Medicine, University of Kentucky, Lexington, Kentucky
*
Hospital Infections Program, CID, Centers for Disease Control, Atlanta, GA30333

Abstract

In the neonatal intensive care unit (NICU) of one hospital, 16 infants became colonized or infected with multiply-resistant Escherichia coli (MR-E.coli) over an 8-month period. Isolates were obtained from blood, urine, and sputum of three patients and from rectal surveillance cultures of 13 patients. The one patient with the blood isolate died. A matched case-control study identified continuous feeding (nine of 16 cases vs. one of 16 controls, p ≤ 0.001) and receipt of aminoglycosides (p ≤ 0.03) as risk factors. For case-babies not exposed to continuous feeding, duration of bolus feeding was significantly greater than for their controls (cases, 22 days; controls, 7 days; p ≤ 0.02). All 16 isolates were the same serotype and were resistant to amikacin, tobramycin, kanamycin, and gentamicin. The epidemiologic investigation suggested that MR-E. coli may have spread from person-to-person on the hands of personnel and that MR-E. coli persisted in the NICU for 8 months until effective control measures were instituted.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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