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Infection

, Volume 23, Issue 2, pp 76–80 | Cite as

Epidemiology and attack index of gram-negative bacteria causing invasive infection in three special-care neonatal units and risk factors for infection

  • Birgitta Fryklund
  • L. G. Burman
  • Kjell Tullus
Originalia

Summary

Of 13 consecutive episodes of gram-negative septicemia (Escherichia coli eight,Klebsiella oxytoca four,Klebsiella pneumoniae one) among 113 infants in three specialcare neonatal units studied, five episodes were epidemiologically related according to a novel fingerprinting method for enterobacteria. In ten episodes the invasive phenotype was found in the fecal flora of up to 54% of the fellow infants in the same ward and for periods of up to 70 days. Two units exchanged patients, which further promoted the transmission of invasive strains. The attack index was highest for certainE. coli strains, generally low forK. oxytoca strains, but lowest for otherE. coli strains. The infants contracting septicemia had lower birth weight (p=0.04) or were more often classified as high-risk infants than matched non-infected fecal carriers of the invasive strains (p=0.04). In summary, gram-negative neonatal septicemia was either due to an apparently high-virulent strain capable of attacking the single full-term infant carrier or a high-colonizing phenotype of lower apparent virulence, which occasionally attacked a high-risk infant among a large number of infants colonized.

Keywords

Klebsiella Klebsiella Pneumoniae Coli Strain Invasive Infection Klebsiella Oxytoca 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Epidemiologie und Fallindex gramnegativer, invasiver Infektionen in drei Neugeborenen-Intensivstationen und Risikofaktoren für die Infektion

Zusammenfassung

Von 13 aufeinanderfolgenden Episoden gramnegativer Septikämie (achtEscherichia coli, vierKlebsiella oxytoca, eineKlebsiella pneumoniae), die bei 113 Kindern von drei Neugeborenen-Intensivstationen auftraten, wurden fünf nach neuen Fingerprint-Methoden für Enterobakterien als epidemiologisch assoziiert erkannt. In zehn Episoden fand sich bis zu 70 Tage lang der invasive Phänotyp in der Stuhlflora von bis zu 54% der gleichzeitig behandelten Kinder derselben Station. Zwei Stationen hatten Patienten ausgetauscht, was die Verbreitung der invasiven Stämme weiter begünstigte. Der Fallindex war für bestimmteE. coli-Stämme am höchsten, fürK. oxytoca im allgemeinen gering und bei anderenE. coli-Stämmen am niedrigsten. Kinder, die eine Septikämie entwickelten, hatten ein niedrigeres Geburtsgewicht (p=0,04) oder wurden häufiger als Hockrisikokinder eingestuft als Vergleichskinder, die den invasiven Stamm im Stuhl hatten aber nicht infiziert waren (p=0,04). Die gramnegative Neugeborenensepsis war folglich entweder auf einen hochvirulenten Stamm zurückzuführen, der fähig war, ein reifes, besiedeltes Neugeborenes zu befallen oder einen hochgradig kolonisierenden Phänotyp eines Stammes mit geringerer offensichtlicher Virulenz, der gelegentlich ein Hochrisikokind unter einer großen Zahl kolonisierter Kinder befiel.

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Copyright information

© MMV Medizin Verlag GmbH 1995

Authors and Affiliations

  • Birgitta Fryklund
    • 1
  • L. G. Burman
    • 1
  • Kjell Tullus
    • 2
  1. 1.Dept. of BacteriologySwedish Institute for Infectious Disease ControlStockholm
  2. 2.Dept. of PaediatricsSt. Göran's Children's HospitalStockholmSweden

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