Epidemiology of CRKP Infection Outbreak in a Neonatal Intensive Care Unit

Weijie LI; Liqin CHEN; Yaling LI; Yonghui HAN; Xiaojuan LI; Ruogu WANG

doi:10.12259/j.issn.2095-610X.S20231223

Volume 44 Issue 12

Dec. 2023

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Article Navigation > Journal of Kunming Medical University > 2023 > 44(12): 144-149

Weijie LI, Liqin CHEN, Yaling LI, Yonghui HAN, Xiaojuan LI, Ruogu WANG. Epidemiology of CRKP Infection Outbreak in a Neonatal Intensive Care Unit[J]. Journal of Kunming Medical University, 2023, 44(12): 144-149. doi: 10.12259/j.issn.2095-610X.S20231223

Citation:

Weijie LI, Liqin CHEN, Yaling LI, Yonghui HAN, Xiaojuan LI, Ruogu WANG. Epidemiology of CRKP Infection Outbreak in a Neonatal Intensive Care Unit[J]. Journal of Kunming Medical University, 2023, 44(12): 144-149. doi: 10.12259/j.issn.2095-610X.S20231223

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Epidemiology of CRKP Infection Outbreak in a Neonatal Intensive Care Unit

doi: 10.12259/j.issn.2095-610X.S20231223

Infection Management Department，Kunming Children's Hospital，Kunming Yunnan 650228，China

Received Date: 2023-09-20
Available Online: 2023-12-20
Publish Date: 2023-12-25

Abstract

Abstract

Objective To analyze the epidemiological characteristics of an outbreak of carbapenem resistant Klebsiella pneumoniae（CRKP） hospital infection in the neonatal intensive care unit（NICU） , and to explore possible causes of the outbreak. Methods Case analysis, epidemiological studies and environmental detection methods were used to investigate the detection of CRKP in the NICU of a hospital from March 11, 2022 to May 3, 2022, and the causes and corresponding prevention and control measures were analyzed. Results This CRKP outbreak in the NICU occurred in two phases. The first phase was from March 11, 2022, to March 30, 2022, during which 3 people contracted CRKP hospital infections. The second phase was from April 13, 2022, to May 3, 2022, during which 4 people contracted CRKP hospital infections. The source of the hospital infection outbreak was patient No.1. All 13 CRKP cases showed sensitivity only to amikacin and tigecycline, with intermediate sensitivity to levofloxacin, and high resistance to other antibiotics. All 13 CRKP cases carried resistant genes for metalloenzymes. After the outbreak, the ward environment was sampled three times, with 35 samples taken in total, and 14 of them tested positive for CRKP. After strict environmental cleaning, disinfection, and multiple control measures, no new hospital infection cases similar to this outbreak were detected after May 13, 2022. Conclusion The outbreak of NICU hospital infections may be due to the contamination of the ward environment, medical equipment, and inadequate hand hygiene of medical staff, leading to its spread. Therefore, strict cleaning and disinfection of the environmental surfaces, strengthening hand hygiene of medical staff, and implementing multiple measures can effectively control hospital infections of CRKP.
- CRKP,
- Hospital Infection,
- Newborns,
- Hospital Infection Outbreak,
- Epidemiology

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References(18)

References

[1]	陈丽琴,韩永慧,李伟杰,等. 某儿童医院PICU一起疑似CRKP医院感染暴发的流行病学调查[J]. 中国感染控制杂志,2020,19(12):1108-1113.
[2]	董晓彤,杨寒,李丽丽,等. 儿童下呼吸道感染耐碳青霉烯类肺炎克雷伯菌耐药性与毒力基因分析[J]. 中华医院感染学杂志,2023,33(11):1721-1725.
[3]	杨丽玲,周湘君,郑武娟,等. 儿童多重耐药肺炎克雷伯菌感染危险因素分析[J]. 儿科药学杂志,2023,29(2):18-23.
[4]	全国耐药细菌监测网. 2020年全国耐药细菌监测报告[EB/OL]. （2021-11-17）[2023-9-4]. http://www. carss. cn/Report/Details?aId=808.
[5]	World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumanni and Pseudomonas aeruginosa in healthcare facilities [EB/OL]. （2017-11-1） [2023-9-4].https://iris.who.int/bitstream/handle/10665/259462/9789241550178-eng.pdf.
[6]	Centers for disease control and prevention. Facility guidance for control of carbapenem-resistant Enterobacteriaceae[EB/OL]. （2015-11） [2023-9-4]. https://www.cdc. gov/hai/pdfs/cre/cre-guidance-508.pdf.
[7]	胡付品,郭燕,朱德妹,等. 2021年CHINET中国细菌耐药监测[J]. 中国感染与化疗杂志,2022,22(5):521-530.
[8]	Tumbarello M,Trecarichi E M,De Rosa F G,et al. Infections caused by KPC-producing Klebsiella pneumoniae: Differences in therapy and mortality in a multicentre study[J]. J Antimicrob Chemother,2015,70(7):2133-2143. doi: 10.1093/jac/dkv086
[9]	Centers for disease control and prevention. CDC partners estimate healthcare cost of Antibiotic-resistant Infections[EB/OL]. （2021-4） [2023-9-4]. https://www.cdc.gov/drugresistance/solutions-initiative/stories/partnership-estimates-healthcare-cost.html.
[10]	World Health Organization. Global shortage of innovative antibiotics fuels emergence and spread of drug-resistance[EB/OL]. （2021-4-15）[2023-9-4]. https://www.who.int/news/item/15-04-2021-global-shortage-of-innovative-antibiotics-fuels-emergence-and-spread-of- drug-resistance.
[11]	Centers for disease control and prevention. Guidelines for the prevention of intravascular catheter-related infections[EB/OL]. （2017-11）[2023-9-4]. https://www.cdc.gov/infectioncontrol/pdf/guidelines/bsi-guidelines-H.pdf.
[12]	李婷,刘鹏,朱昱蓉. 2016-2021年重症医学科中心静脉导管相关血流感染病原菌分布及耐药性分析[J]. 检验医学与临床,2023,20(1):49-53.
[13]	任军红,吴安华,胡必杰,等. 新生儿重症监护病房医务人员手卫生依从性多中心干预研究[J]. 中国感染控制杂志,2015,14(8):557-560.
[14]	中华人民共和国国家卫生和计划生育委员会. 医院感染暴发控制指南: WS/T 524-2016[S]. 北京: 中国标准出版社, 2016.
[15]	王明贵,X Guan,L He,等. 广泛耐药革兰阴性菌感染的实验诊断、抗菌治疗及医院感染控制: 中国专家共识[J]. 中国感染与化疗杂志,2017,17(1):82-92.
[16]	中华人民共和国卫生部. 医院感染诊断标准（试行）[S]. 中华医学杂志, 2001, 81（5）: 314-320.
[17]	中华人民共和国国家质量监督检验检疫总局, 中国国家标准化管理委员会. 医院消毒卫生标准;GB15982-2012[S]. 北京: 中国标准出版社, 2012.
[18]	殷丽军,杨韦菁,缪瑾,等. 新生儿重症监护患者耐碳青霉烯类肺炎克雷伯菌定植发展为感染的危险因素分析[J]. 中国感染控制杂志,2022,21(1):15-21.

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