Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak
Abstract Background Enterobacter cloacae species is responsible for nosocomial outbreaks in vulnerable patients in neonatal intensive care units (NICU). The environment can constitute the reservoir and source of infection in NICUs. Herein we report the impact of preventive measures implemented after...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05406-8 |
| _version_ | 1818200867384328192 |
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| author | Alexandrine Ferry Frank Plaisant Christophe Ginevra Yann Dumont Jacqueline Grando Olivier Claris François Vandenesch Marine Butin |
| author_facet | Alexandrine Ferry Frank Plaisant Christophe Ginevra Yann Dumont Jacqueline Grando Olivier Claris François Vandenesch Marine Butin |
| author_sort | Alexandrine Ferry |
| collection | DOAJ |
| description | Abstract Background Enterobacter cloacae species is responsible for nosocomial outbreaks in vulnerable patients in neonatal intensive care units (NICU). The environment can constitute the reservoir and source of infection in NICUs. Herein we report the impact of preventive measures implemented after an Enterobacter cloacae outbreak inside a NICU. Methods This retrospective study was conducted in one level 3 NICU in Lyon, France, over a 6 year-period (2012–2018). After an outbreak of Enterobacter cloacae infections in hospitalized neonates in 2013, several measures were implemented including intensive biocleaning and education of medical staff. Clinical and microbiological characteristics of infected patients and evolution of colonization/infection with Enterobacter spp. in this NICU were retrieved. Moreover, whole genome sequencing was performed on 6 outbreak strains. Results Enterobacter spp. was isolated in 469 patients and 30 patients developed an infection including 2 meningitis and 12 fatal cases. Preventive measures and education of medical staff were not associated with a significant decrease in patient colonisation but led to a persistent decreased use of cephalosporin in the NICU. Infection strains were genetically diverse, supporting the hypothesis of multiple hygiene defects rather than the diffusion of a single clone. Conclusions Grouped cases of infections inside one setting are not necessarily related to a single-clone outbreak and could reveal other environmental and organisational problematics. The fight against implementation and transmission of Enterobacter spp. in NICUs remains a major challenge. |
| first_indexed | 2024-12-12T02:44:29Z |
| format | Article |
| id | doaj.art-8e5a295413c7462286d5895223701658 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T02:44:29Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-8e5a295413c7462286d58952237016582022-12-22T00:41:05ZengBMCBMC Infectious Diseases1471-23342020-09-012011710.1186/s12879-020-05406-8Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreakAlexandrine Ferry0Frank Plaisant1Christophe Ginevra2Yann Dumont3Jacqueline Grando4Olivier Claris5François Vandenesch6Marine Butin7Hospices Civils de Lyon, Service de Néonatologie et Réanimation NéonataleHospices Civils de Lyon, Service de Néonatologie et Réanimation NéonataleHospices Civils de Lyon, Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Groupement Hospitalier NordHospices Civils de Lyon, Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Groupement Hospitalier NordHospices Civils de Lyon, Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Groupement Hospitalier NordHospices Civils de Lyon, Service de Néonatologie et Réanimation NéonataleHospices Civils de Lyon, Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Groupement Hospitalier NordHospices Civils de Lyon, Service de Néonatologie et Réanimation NéonataleAbstract Background Enterobacter cloacae species is responsible for nosocomial outbreaks in vulnerable patients in neonatal intensive care units (NICU). The environment can constitute the reservoir and source of infection in NICUs. Herein we report the impact of preventive measures implemented after an Enterobacter cloacae outbreak inside a NICU. Methods This retrospective study was conducted in one level 3 NICU in Lyon, France, over a 6 year-period (2012–2018). After an outbreak of Enterobacter cloacae infections in hospitalized neonates in 2013, several measures were implemented including intensive biocleaning and education of medical staff. Clinical and microbiological characteristics of infected patients and evolution of colonization/infection with Enterobacter spp. in this NICU were retrieved. Moreover, whole genome sequencing was performed on 6 outbreak strains. Results Enterobacter spp. was isolated in 469 patients and 30 patients developed an infection including 2 meningitis and 12 fatal cases. Preventive measures and education of medical staff were not associated with a significant decrease in patient colonisation but led to a persistent decreased use of cephalosporin in the NICU. Infection strains were genetically diverse, supporting the hypothesis of multiple hygiene defects rather than the diffusion of a single clone. Conclusions Grouped cases of infections inside one setting are not necessarily related to a single-clone outbreak and could reveal other environmental and organisational problematics. The fight against implementation and transmission of Enterobacter spp. in NICUs remains a major challenge.http://link.springer.com/article/10.1186/s12879-020-05406-8Enterobacter cloacaeNICUOutbreakCephalosporinsBiocleaning |
| spellingShingle | Alexandrine Ferry Frank Plaisant Christophe Ginevra Yann Dumont Jacqueline Grando Olivier Claris François Vandenesch Marine Butin Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak BMC Infectious Diseases Enterobacter cloacae NICU Outbreak Cephalosporins Biocleaning |
| title | Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak |
| title_full | Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak |
| title_fullStr | Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak |
| title_full_unstemmed | Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak |
| title_short | Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak |
| title_sort | enterobacter cloacae colonisation and infection in a neonatal intensive care unit retrospective investigation of preventive measures implemented after a multiclonal outbreak |
| topic | Enterobacter cloacae NICU Outbreak Cephalosporins Biocleaning |
| url | http://link.springer.com/article/10.1186/s12879-020-05406-8 |
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