Nosocomial klebsiella infection in a neonatal unit: identification of risk factors for gastrointestinal colonization.

C. G. Mayhall, V. A. Lamb, C. M. Bitar, K. B. Miller, E. Y. Furse, B. V. Kirkpatrick, S. M. Markowitz, J. M. Veazey, F. L. Macrina

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Sequential outbreaks of infection due to gentamicin-resistant Klebsiella pneumoniae (GRKP) types 30 and 19 occurred in the neonatal intensive care unit (NICU) at the Medical College of Virginia in 1977 and 1978. The extensive epidemiologic investigation carried out included a case-control study, careful review of aseptic technique, and cultures from nursery staff and environment. The gastrointestinal (GI) tracts of the patients were the reservoirs for GRKP, and the epidemic strain was transmitted by hands of personnel. The case-control study showed a significant relationship between acquisition of GRKP by patients and oropharyngeal and GI instrumentation, including use of bag resuscitation, oropharyngeal suctioning, and use of nasogastric feeding tubes. The findings of the case-control study were supported by observation of the patient care techniques practiced by NICU staff. Institution of control measures based on results of the epidemiologic investigation of the first outbreak rapidly brought the second outbreak under control, even though cohorting or use of routine isolation was not possible. Whereas GI colonization and hand transmission have been described previously in outbreaks of K. pneumoniae infections in NICUs, this study is the first to document the mode of inoculation of patients' GI tracts by contaminated hands of personnel.

Original languageEnglish (US)
Pages (from-to)239-246
Number of pages8
JournalInfection Control
Volume1
Issue number4
StatePublished - Jul 1980
Externally publishedYes

Fingerprint

Klebsiella Infections
Klebsiella pneumoniae
Cross Infection
Disease Outbreaks
Gentamicins
Case-Control Studies
Hand
Neonatal Intensive Care Units
Gastrointestinal Tract
Culture Techniques
Nurseries
Enteral Nutrition
Resuscitation
Patient Care
Observation
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mayhall, C. G., Lamb, V. A., Bitar, C. M., Miller, K. B., Furse, E. Y., Kirkpatrick, B. V., ... Macrina, F. L. (1980). Nosocomial klebsiella infection in a neonatal unit: identification of risk factors for gastrointestinal colonization. Infection Control, 1(4), 239-246.

Nosocomial klebsiella infection in a neonatal unit : identification of risk factors for gastrointestinal colonization. / Mayhall, C. G.; Lamb, V. A.; Bitar, C. M.; Miller, K. B.; Furse, E. Y.; Kirkpatrick, B. V.; Markowitz, S. M.; Veazey, J. M.; Macrina, F. L.

In: Infection Control, Vol. 1, No. 4, 07.1980, p. 239-246.

Research output: Contribution to journalArticle

Mayhall, CG, Lamb, VA, Bitar, CM, Miller, KB, Furse, EY, Kirkpatrick, BV, Markowitz, SM, Veazey, JM & Macrina, FL 1980, 'Nosocomial klebsiella infection in a neonatal unit: identification of risk factors for gastrointestinal colonization.', Infection Control, vol. 1, no. 4, pp. 239-246.
Mayhall CG, Lamb VA, Bitar CM, Miller KB, Furse EY, Kirkpatrick BV et al. Nosocomial klebsiella infection in a neonatal unit: identification of risk factors for gastrointestinal colonization. Infection Control. 1980 Jul;1(4):239-246.
Mayhall, C. G. ; Lamb, V. A. ; Bitar, C. M. ; Miller, K. B. ; Furse, E. Y. ; Kirkpatrick, B. V. ; Markowitz, S. M. ; Veazey, J. M. ; Macrina, F. L. / Nosocomial klebsiella infection in a neonatal unit : identification of risk factors for gastrointestinal colonization. In: Infection Control. 1980 ; Vol. 1, No. 4. pp. 239-246.
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