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Abstract
Background:
Extended
spectrum beta lactamase (ESBL)-producing Klebsiella
pneumoniae have been occasionally reported as a cause of
septicemia outbreak among pediatric patients in medical
literature. We aimed to study the source of an outbreak
of ESBL-producing K. pneumoniae in the Neonatal
Intensive care Unit (NICU) at a tertiary care hospital
in South India.
Methods: The outbreak was investigated by
phenotypically typing the isolates followed by random
amplified polymorphic DNA analysis (RAPD). A total of 31
K. pneumoniae, consisting of 27 blood isolates from
neonates and 4 environmental isolates were studied.
Antibiotic susceptibility patterns were determined using
standard disc diffusion methods; ESBL production was
tested both phenotypically and genotypically. The
strains were typed using two primers AP4 and HLWL74.
Results: Except 2 environmental strains, all were
found to be ESBL producers and of ESBL types TEM-1,
SHV-12 and CTX-M- 15. Two different antibiotic
resistance patterns were identified and the RAPD typing
revealed two profiles. Phenotypic and genotypic analyses
showed that 2 environmental strains had been responsible
for the outbreak.
Conclusion: Safe clinical practices should be
followed in neonatal wards to prevent spread of
infection. This is the first report of blaCTX-M-15
producing K.pneumoniae and the first outbreak in our
hospital due to CTX-M-15 producing K.pneumoniae.
Keywords:
Extended spectrum β lactamase, Neonatal Intensive care
Unit, Klebsiella pneumoniae, Outbreak |
