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. 2017 Dec 30;58(4):E302-E307.
doi: 10.15167/2421-4248/jpmh2017.58.4.692. eCollection 2017 Dec.

VIM- Klebsiella oxytoca outbreak in a Neonatal Intensive Care Unit. This time it wasn't the drain

R Herruzo  1 , G Ruiz  2 , S Gallego  3 , J Diez  3 , A Sarria  2 , F Omeñaca  4
Affiliations

VIM- Klebsiella oxytoca outbreak in a Neonatal Intensive Care Unit. This time it wasn't the drain

R Herruzo et al. J Prev Med Hyg. .

Abstract

Objective: We describe an outbreak of VIM-carbapenemase Klebsiella oxytoca (VIM-Kox) in a NICU.

Materials and methods: Prospective Epidemiological Surveillance:Systematically (weekly screening cultures) or on admission, if the patient had a history of previous colonization by VIM-Kox.Clinical cultures, done if infection was suspected.Other possible microorganism sources were investigated: their mothers (rectal microbiota), milk packages and preparation apparata in the lactodietary section, echocardiagram transductors, cribs, the sinks (faucets and drains), washing bowls, etc.Molecular typing was performed using the DiversiLab (bioMérieux) system on all VIM-Kox isolated from environment or patients (one by neonate).

Results: We identified 20 VIM-Kox cases, the most only presented colonization, but 4 showed infection. Three of the ten sinks (drains) in our NICU, were positive for VIM-Kox. Another four drains harbored P.aeruginosa, S. maltophilia and/or Enterobacter sp. Nevertheless the VIM-Kox bacteria in the sinks (drains) were not the same as those in the patients, who showed three different strains.

Conclusions: A VIM-Kox colonization or infection outbreak in a NICU is described. Rather than environment, not even drains, the source of the outbreak was other patients. The outbreak was relatively brief, as a result of the rapidness with which appropriate measures were taken and followed.

Keywords: NICU; Sink (drain); VIM-Klebsiella oxytoca.

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Figures

Fig. 1.
Fig. 1.
Cummulative incidence (%) for VIM-K. Oxytoca vs other VIM Enterobacteriaceae in NICU.
Fig. 2.
Fig. 2.
Summary of VIM-K. oxytoca cases (Feb.-May) in NICU: location of cases and faucets-sinks.
See this image and copyright information in PMC

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