Article

Folia Microbiologica

, Volume 58, Issue 3, pp 229-234

First online:

E. coli outbreak in a neonate intensive care unit in a general hospital in Mexico City

  • Erika Margarita Carrillo-CasasAffiliated withDepartamento de Biología Molecular e Histocompatibilidad, Hospital General “Dr. Manuel Gea González”
  • , Zaydy Suástegui-UrquijoAffiliated withDepartamento de Ecología de Agentes Patógenos, Hospital General “Dr. Manuel Gea González”
  • , Sara Arroyo-EscalanteAffiliated withDepartamento de Laboratorio Clínico, Hospital General “Dr. Manuel Gea González”
  • , Rosario Morales-EspinosaAffiliated withDepartamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México
  • , David Moncada-BarrónAffiliated withDepartamento de Laboratorio Clínico, Hospital General “Dr. Manuel Gea González”
  • , Lorena Hernández-DelgadoAffiliated withServicio de Pediatría, Hospital General “Dr. Manuel Gea González”
  • , José Luis Méndez-SánchezAffiliated withDepartamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México
  • , Gabriela Delgado-SapiénAffiliated withDepartamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México
  • , Armando Navarro-OcañaAffiliated withDepartamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México
    • , Ángel Manjarrez-HernándezAffiliated withDepartamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México
    • , Juan Xicohtencatl-CortesAffiliated withLaboratorio de Bacteriología Intestinal, Hospital Infantil de México “Federico Gómez”
    • , Rigoberto Hernández-CastroAffiliated withDepartamento de Ecología de Agentes Patógenos, Hospital General “Dr. Manuel Gea González” Email author 

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Abstract

Nosocomial infections are a major cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs). The aim of this paper was to describe an outbreak of Escherichia coli among infants admitted to the NICU of the General Hospital “Dr. Manuel Gea Gonzalez” in May of 2008. The isolated E. coli strains were identified using standard biochemical methods. The susceptibilities of these strains were analysed by determining their minimal inhibitory concentrations. Following this, their molecular relationships to each other were assessed by pulsed field gel electrophoresis (PFGE) analysis and corroborated by serology. Twelve E. coli strains were isolated from blood, urine, or indwelling catheter samples from five cases of preterm infants within a 3-day period. Patients were admitted to the NICU of the general hospital and, during the outbreak, developed sepsis caused by E. coli. For four of the patients, the average age was 23 days, while one patient was a 3-month-old infant. Prior to sepsis, the infants had received assisted ventilation and hyperalimentation through a central venous catheter. Two profiles were observed by PFGE; profile A was identified as the outbreak’s cause and an outcome of cross-infection, while profile B showed genetic differences but serologically it was identified as part of the same serotype. We conclude that E. coli colonised the patients through horizontal transmission. A focal source of the microorganism in this outbreak was not identified, but cross-transmission through handling was the most probable route.