| Molecular-epidemiologic study on outbreak of colonization by extended spectrum β-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit |
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Nu-Lee Jun1, Mi-Na Kim2, Jae-Sim Jeong3, Yang-Soo Kim3, Ellen Ai-Rhan Kim1, Ki-Soo Kim1, Soo-Young Pi1 |
1Division of Neonatology, Department of Pediatrics, Asan Medical Center, University of Ulsan College
2Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seo
3Department of Hospital Infection Control, Asan Medical Center, University of Ulsan College of Medici |
| 신생아 중환자실에서 extended spectrum β-lactamase를 생성하는 Klebsiella pneumoniae 집단 보균 발생의 분자 역학적 조사 및 추적관찰 |
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전누리1, 김미나2, 정재심3, 김양수3, 김애란1, 김기수1, 피수영1 |
1울산대학교 의과대학 서울아산병원 신생아과
2울산대학교 의과대학 서울아산병원 진단검사의학과
3울산대학교 의과대학 서울아산병원 감염관리팀 |
Correspondence:
Ellen Ai-Rhan Kim, Email: arkim@amc.seoul.kr
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| Abstract |
Purpose
: The aims of this study included assessment of molecular-epidemiologic features during an outbreak of colonization of extended spectrum β-lactamase producing Klebsiella pneumoniae(ESBL- KPN) and re-evaluation of their colonized status one year later.
Methods
: Rectal swab cultures for ESBL-KPN from all hospitalized infants and newly admitted infants were obtained during the outbreak of colonization from July to December, 2000. The pattern of XbaI-digested chromosomal DNA of isolates were analyzed by pulsed-field gel electrophoresis. Weekly rectal swab cultures were obtained during the outbreak until patients were either discharged or decolonized. Patients discharged after being colonized had follow up stool cultures a year later.
Results
: A total of 80 patients(28.5 percent) were colonized. Of those, 53 whose pulsed-field gel electrophoresis(PFGE) was possible only once, were ESBL-KPN grouped into six cluster clones and 10 single clones : 28 patients(52.8 percent) were colonized with type A, the most common clone, followed by type B in 11 patients(20.8 percent). Of those 12 patients in whom serial PFGE was done more than twice, type A was predominant. Narrowed-down in strains occurred from types A, B, C, D and three single clones at initiation of the study into types A and type B after three months of strict infection control. Among 75 patients(93.7 percent) who were sent home after being colonized, 30 patients were re-called for stool cultures a year later : All of them were decolonized.
Conclusion
: This study demonstrates the importance of infection control as the diversity of ESBL- KPN strains could be narrowed into fewer strains. Colonization of ESBL-KPN could be reversed upon return to the community. |
| Key Words:
Extended spectrum β-lactamase producing K. pneumoniae, Pulsed-field-gel-electrophoresis, Colonizatio |
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