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Outbreak of NDM-1– and OXA-181–Producing Klebsiella pneumoniae Bloodstream Infections in a Neonatal Unit, South Africa
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Outbreak of NDM-1– and OXA-181–Producing Klebsiella pneumoniae Bloodstream Infections in a Neonatal Unit, South Africa
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Journal Article
Outbreak of NDM-1– and OXA-181–Producing Klebsiella pneumoniae Bloodstream Infections in a Neonatal Unit, South Africa
2023
Overview
After an increase in carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections and associated deaths in the neonatal unit of a South Africa hospital, we conducted an outbreak investigation during October 2019-February 2020 and cross-sectional follow-up during March 2020-May 2021. We used genomic and epidemiologic data to reconstruct transmission networks of outbreak-related clones. We documented 31 cases of culture-confirmed CRKP infection and 14 deaths. Two outbreak-related clones (bla
sequence type [ST] 152 [n = 16] and bla
ST307 [n = 6]) cocirculated. The major clone bla
ST152 accounted for 9/14 (64%) deaths. Transmission network analysis identified possible index cases of bla
ST307 in October 2019 and bla
ST152 in November 2019. During the follow-up period, 11 new cases of CRKP infection were diagnosed; we did not perform genomic analysis. Sustained infection prevention and control measures, adequate staffing, adhering to bed occupancy limits, and antimicrobial stewardship are key interventions to control such outbreaks.
Publisher
U.S. National Center for Infectious Diseases,Centers for Disease Control and Prevention
Subject
/ Analysis
/ Anti-Bacterial Agents - pharmacology
/ Anti-Bacterial Agents - therapeutic use
/ Audits
/ Babies
/ Bacterial Proteins - genetics
/ blaNDM
/ Bloodstream Infections in a Neonatal Unit, South Africa
/ Carbapenem-Resistant Enterobacteriaceae - genetics
/ Control
/ COVID-19
/ Genomes
/ healthcare-associated outbreaks
/ Humans
/ Ions
/ Klebsiella Infections - drug therapy
/ Klebsiella Infections - epidemiology
/ Klebsiella pneumoniae - genetics
/ neonates
/ Nurses
/ Outbreak of NDM-1– and OXA-181–Producing
/ Sepsis
