Extended Spectrum β Lactamase producing Klebsiella pneumoniae in neonatal intensive care unit
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- Krishna, B.V.S., Patil, A.B. & Chandrasekhar, M.R. Indian J Pediatr (2007) 74: 627. doi:10.1007/s12098-007-0111-1
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As infections due to Extended Spectrun β Lactamase (ESβL) producing Klebsiella pneumoniae were increasing in the NICU at Karnataka Institute of Medical Sciences Hospital, Hubli, India, the present study was carried out to identify any environmental sources and the mode of transmission.
Environmental samples from various sites were collected monthly for a period of six months.
ESβL producing K. pneumoniae were isolated from all the sites except room air at least on one occasion. ESβL producing K. pneumoniae was always isolated from one of the incubators, medicine trolley and sink; while at least one of the health care workers carried it in the hands four out of six times tested. ESβL producing K. pneumoniae with similar antibiogram were also isolated from the clinical samples obtained from the neonates.
Widespread use of third generation cephalosporins as a pre-emptive antibiotic for suspected cases of septicaemia may have contributed to emergence of ESβL producing K. pneumoniae in addition to other risk factors. ESβL producing K. pneumoniae have extensively colonised the environment of the NICU. Transmission of these pathogens to the neonates has probably occurred through the healthcare workers. Efforts to improve hand hygiene among the healthcare workers and mothers are urgently needed.