TY  -  JOUR
AU  -  Cambieri, Patrizia
AU  -  Caltagirone, Mariasofia
AU  -  Bitar, Ibrahim
AU  -  Corbella, Marta
AU  -  Dalla Valle, Claudia
AU  -  Carrano, Francesco Maria
AU  -  Stronati, Mauro
AU  -  Pagani, Laura
AU  -  Marone, Piero
AU  -  Muzzi, Alba
T1  -  Contenimento di un focolaio epidemico 
di Klebsiella pneumoniae ESβL-produttore (KP-ESβL) 
in un reparto di terapia intensiva neonatale
PY  -  2015
Y1  -  2015-10-01
DO  -  10.1716/2166.23434
JO  -  GIMPIOS
JA  -  Gimpios
VL  -  5
IS  -  4
SP  -  161
EP  -  165
PB  -  Il Pensiero Scientifico Editore
SN  -  1122-407X
Y2  -  2026/06/21
UR  -  http://dx.doi.org/10.1716/2166.23434
N2  -  Summary Introduction. This paper reports measures of surveillance and control adopted for the containment of an ESβL producing Klebsiella pneumoniae (KP-ESβL) outbreak of infections/colonizations occurred in the Neonatal intensive-care unit (NICU) and Neonatology division of the Fondazione IRCCS Policlinico San Matteo of Pavia between April and August 2013. Methods. The control of hospital-acquired infections (HAI) relies on the adoption of correct care practices, patients’ screening, isolation of the colonized/infected subjects and infection treatment. Taking these into account, since April 2013, each newborn in San Matteo Hospital of Pavia hospitalized in NICU underwent rectal swabs for surveillance purpose and environmental samplings were taken in potentially critical ward areas. At the same time, isolation/cohorting of infected/colonized infants were performed in the outpatients both in the NICU and the Division of Neonatology. Subsequently, since August 2013, both the departments where divided in two areas (colonized/infected zone vs. colonization/infection free zone) with separate dedicated health care workers. Strains of KP-ESβL of particular relevance were subject to molecular and clonal typing. Results. In the considered timeframe, 293 patients were hospitalized. Among them, 66 out of 293 (23%) resulted colonized and 18 out of 293 (6%) infected by KP-ESβL. Eight patients had a severe infection, but none died. From the analysis of environment samplings emerged the evidence of an initial presence of KP-ESβL in two spots close to the cradles of colonized/infected patients. The creation of two separate areas in the wards allowed for a progressive reduction in colonized/infected infants and, ultimately, outbreak resolution. Molecular analysis demonstrated the monoclonal origin of the CTX-M-15 producers’ strains. Discussion. Ward separation and meticulous adherence to essential practices for infection control has allowed for the successful resolution of the ESβL Producing Klebsiella pneumoniae outbreak. The role of the Microbiology Lab is central for the prompt identification and characterization of hospital outbreaks of multi-resistant microorganisms such as KP-ESβL.
ER  -