The outbreak of nosocomial sepsis and meningitis caused by Escherichia coli in a neonatal intensive care unit
Abstract number: 1134_04_9
Mueller-Premru M., Mole H., Kornhauser Cerar L.
In three premature babies, treated in the Neonatal Intensive Care unit (NICU) in a period of 37 days of the year 2004, late-onset Escherichia coli sepsis and meningitis were recorded. Because babies were treated in the same room, the possibility of an outbreak was postulated and bacterial typing was requested.
Three babies were treated for some time together in the same six-bed room of NICU. Their gestational age was from 2429 weeks and their birth weight from 660 to 1070 g. Two babies needed ventilatory support. The acute onset of illness occurred in the first baby at the age of 21 days. In the second and the third baby the illness occurred 32 and 37 days later at the age of 26 days and of 16 days, respectively; at this time the first baby has already left the room. E. coli, susceptible to tested antibiotics, was isolated from blood and CSF of all neonates. It was also isolated from tracheal aspirate of the first and nasopharynx and urine of the third neonate, but in none of the other samples. All babies were successfully treated with cefotaxime. Capsular antigen of invasive isolates was determined by agglutination, using bacterial antigen kit (Wellcogen). Typing was performed by macrorestriction analysis of chromosomal DNA in pulsed-field gel electrophoresis (PFGE). Bacterial DNA was isolated in agarose plugs and digested by the rare cutting enzyme Xba I (Roche) during overnight incubation. DNA fragments were separated in molecular biology-grade agarose (Bio Rad) in a CHEF DR III drive module in 0.5 M TBE running buffer.
E. coli isolates from all babies carried K1 capsular antigen. Macrorestriction analysis of chromosomal DNA showed that all isolates had identical PFGE pattern.
Typing confirmed the outbreak of nosocomial sepsis and meningitis caused by E. coli in three neonates. Unfortunately, staff and environmental samples were not taken for investigation. By reinforcement of strict hygienic precautions, the outbreak terminated.
|Session name:||XXIst ISTH Congress|
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