Increased Mortality Associated With a Clonal Outbreak of Ceftazidime-ResistantKlebsiella pneumoniae: A Case–Control Study
- 1 January 2005
- journal article
- Published by Cambridge University Press (CUP) in Infection Control & Hospital Epidemiology
- Vol. 26 (1), 63-68
- https://doi.org/10.1086/502488
Abstract
Objectives: : To determine risk factors for ceftazidime-resistantKlebsiella pneumoniaeinfection and the effect of cef-tazidime-resistantK. pneumoniaeinfection on mortality during an isolated outbreak.Design: : Case–control investigation using clinical and molecular epidemiology and prospective analysis of infection control interventions.Setting: : Surgical intensive care unit of a university-affiliated community hospital.Patients: : Fourteen case-patients infected with ceftazidime-resistantK. pneumoniaeand 14 control-patients.Results: : Ten of 14 case-patients had identical strains by pulsed-field gel electrophoresis. Broad-spectrum antibiotic therapy before admission to the unit was strongly predictive of subsequent ceftazidime-resistantK. pneumoniaeinfection. In addition, patients with ceftazidime-resistantK. pneumoniaeinfection experienced increased mortality (odds ratio, 3.77).Conclusions: : Cephalosporin restriction has been shown to decrease the incidence of nosocomial ceftazidime-resistantK. pneumoniae. However, isolated clonal outbreaks may occur due to lapses in infection control practices. Reinstatement of strict handwashing, thorough environmental cleaning, and repeat education led to termination of the outbreak. A distinct correlation between ceftazidime-resistantK. pneumoniaeinfection and mortality supports the important influence of antibiotic resistance on the outcome of serious bacterial infections.Keywords
This publication has 29 references indexed in Scilit:
- Considerations in Control and Treatment of Nosocomial Infections Due to Multidrug‐ResistantAcinetobacter baumanniiClinical Infectious Diseases, 2003
- Extended-Spectrum β-Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance ThreatClinical Microbiology Reviews, 2001
- Outbreak of a Multiresistant Klebsiella pneumoniae Strain in an Intensive Care Unit: Antibiotic Use as Risk Factor for Colonization and InfectionClinical Infectious Diseases, 2000
- Control of a Prolonged Outbreak of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in a University HospitalClinical Infectious Diseases, 1999
- Skin Hygiene and Infection Prevention: More of the Same or Different Approaches?Clinical Infectious Diseases, 1999
- EXTENDED-SPECTRUM β-LACTAMASES AND OTHER ENZYMES PROVIDING RESISTANCE TO OXYIMINO-β-LACTAMSInfectious Disease Clinics of North America, 1997
- The Role of Understaffing in Central Venous Catheter-Associated Bloodstream InfectionsInfection Control & Hospital Epidemiology, 1996
- Outbreak of Multiply Resistant Enterobacteriaceae in an Intensive Care Unit: Epidemiology and Risk Factors for AcquisitionClinical Infectious Diseases, 1996
- Nosocomial Outbreak of Klebsiella Infection Resistant to Late-Generation CephalosporinsAnnals of Internal Medicine, 1993
- CDC definitions for nosocomial infections, 1988American Journal of Infection Control, 1988