Infection Control Following an Outbreak of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Isolated from Catheter-Associated Urinary Tract Infection

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  • Ikeda Yasuhiro
    Infection Control Team, Hyogo Prefectural Central Rehabilitation Hospital
  • Shigemura Katsumi
    Department of Urology, Kobe University Graduate School of Medicine Division of Infectious Diseases, Department of International Health, Kobe University Graduate School of Health Sciences Infection Control Team, Kobe University Hospital
  • Nomi Masashi
    Infection Control Team, Hyogo Prefectural Central Rehabilitation Hospital
  • Tabata Chie
    Infection Control Team, Hyogo Prefectural Central Rehabilitation Hospital
  • Kitagawa Koichi
    Division of Translational Research for Biologics, Department of Internal Related Medicine, Kobe University Graduate School of Medicine
  • Arakawa Soichi
    Department of Urology, Sanda City Hospital
  • Fujisawa Masato
    Department of Urology, Kobe University Graduate School of Medicine

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  • Infection Control Following an Outbreak of Extended-Spectrum Beta-Lactamase-Producing <i>Klebsiella pneumoniae</i> Isolated from Catheter-Associated Urinary Tract Infection

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<p>We present our experience with controlling an outbreak of extended-spectrum beta-lactamase (ESBL)-producing bacteria in catheter-associated urinary tract infection and the measures taken to prevent future outbreaks. In June 2015, 9 out of 44 hospitalized patients in the same ward tested positive for antibiotic-resistant bacteria in urine cultures, including ESBL-producing Klebsiella pneumoniae. Since these bacteria belonged to the same cluster, we concluded this was a localized outbreak. Seven out of 10 environmental tests detected resistant strains at 1,000 colony forming units/cm2 or more. After an outbreak, we undertook periodic monitoring by active surveillance culture (ASC) every 2 months, along with environmental wipe testing. Cleaning regimen was performed through alcohol disinfection 5 or 7 times a day, then changed to complex-type chlorine-based disinfectant cleaner once a day that includes potassium peroxymonosulfate. ASC revealed only one positive case of antibiotic-resistant strain after incorporating new infection controls. Only a few environmental tests were positive for the bacteria after the new cleaning regimen, suggesting this cleaner might be effective for inhibiting outbreaks. Our control measures successfully prevented further outbreak and inhibited the recurrence.</p>

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