caa a22 4500 388034874 CHVBK 20180307125001.0 cr unu---uuuuu 161130e199809 xx s 000 0 eng 10.1086/647897 doi S0195941700005907 pii (NATIONALLICENCE)cambridge-10.1086/647897 Klebsiella Pneumoniae Bloodstream Infections in Neonates in a Hospital in the Kingdom of Saudi Arabia [Elektronische Daten] Abstract Objective: To identify risk factors for Klebsiella pneumoniae bloodstream infections (BSI) in neonates in a hospital in the Kingdom of Saudi Arabia (KSA). Design: Two case-control studies among hospitalized neonates during February 15-May 14, 1991, and a procedural and microbiological investigation. Setting: Hospital A, a maternity and children's hospital in KSA. Patients: Case patients had a blood culture positive for K pneumoniae after >2 days of hospitalization and had no evidence of a nonblood primary site of infection. Results: When the 20 case patients were compared with controls, hospitalization in a critical-care unit (odds ratio [OR], 5.5; 95% confidence interval [CI95], 1.20-51.1; P=.03) was identified as a risk factor. When the case patients were compared with a second set of controls matched by critical-care status, receipt of a particular intravenous fluid (D10%/0.2NS; OR, 11.0; CI95, 1.42-85.2; P=.009) or a blood product (OR undefined; P=.04) were identified as risk factors. Infusates were administered via umbilical catheters for most case and control patients (19/20 vs 15/20, P>.05); catheters were manipulated more frequently in patients in criticalcare units. Umbilical catheter tip, skin, or mucus membrane K pneumoniae colonization occurred in 47% and 53% of evaluated case and control patients, respectively. Available K pneumoniae isolates from blood cultures and colonization sites had identical antimicrobial susceptibility patterns. Emphasis on handwashing, careful preparation and administration of infusates, and aseptic technique for catheter insertion, maintenance, and manipulation was temporally associated with resolution of the epidemic. Conclusions: This outbreak was probably due to infusion therapy practices that led to BSI in nursery patients colonized with K pneumoniae. Both catheter-related infections and extrinsic contamination of infusates may have occurred. Hospital personnel should be aware of their potential to spread nosocomial pathogens from person to person and should implement Centers for Disease Control and Prevention recommendations to decrease nosocomial BSIs. Copyright © The Society for Healthcare Epidemiology of America 1998 Al-Rabea Ayman Abdulaziz The Field Epidemiology Training Program, Ministry of Health, Kingdom of Saudi Arabia Burwen Dale R. Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia Eldeen Mariam A. Fath Maternity and Children's Hospital, Riyadh, Kingdom of Saudi Arabia Fontaine Robert E. The Field Epidemiology Training Program, Ministry of Health, Kingdom of Saudi Arabia Tenover Fred Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia Jarvis William R. Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia Infection Control & Hospital Epidemiology Cambridge University Press 19/9(1998-09), 674-679 0899-823X 19:9<674 1998 19 ICE https://doi.org/10.1086/647897 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1086/647897 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Al-Rabea Ayman Abdulaziz The Field Epidemiology Training Program, Ministry of Health, Kingdom of Saudi Arabia NATIONALLICENCE 700 1- Burwen Dale R. Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia NATIONALLICENCE 700 1- Eldeen Mariam A. Fath Maternity and Children's Hospital, Riyadh, Kingdom of Saudi Arabia NATIONALLICENCE 700 1- Fontaine Robert E. The Field Epidemiology Training Program, Ministry of Health, Kingdom of Saudi Arabia NATIONALLICENCE 700 1- Tenover Fred Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia NATIONALLICENCE 700 1- Jarvis William R. Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia NATIONALLICENCE 773 0- Infection Control & Hospital Epidemiology Cambridge University Press 19/9(1998-09), 674-679 0899-823X 19:9<674 1998 19 ICE CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge