Successful elimination of extended-spectrum beta-lactamase (ESBL)-producing nosocomial bacteria at a neonatal intensive care unit

Borbála Szél, Zsolt Reiger, E. Urbán, Andrea Lázár, Krisztina Mader, Ivelina Damjanova, Kamilla Nagy, Gyula Tálosi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria are highly dangerous to neonates. At our Neonatal Intensive Care Unit (NICU), the presence of these bacteria became so threatening in 2011 that immediate intervention was required. Methods: This study was conducted during a nearly two-year period consisting of three phases: retrospective (9 months), educational (3 months) and prospective (9 months). Based on retrospective data analysis, a complex management plan was devised involving the introduction of the INSURE protocol, changes to the antibiotic regimen, microbiological screening at short intervals, progressive feeding, a safer bathing protocol, staff hand hygiene training and continuous monitoring of the number of newly infected and newly colonized patients. During these intervals, a total of 355 patients were monitored. Results: Both ESBL-producing Enterobacter cloaceae and Klebsiella pneumoniae were found (in both patients and environmental samples). In the prospective period a significant reduction could be seen in the average number of both colonized (26/167 patients; P=0.029) and infected (3/167 patients; P=0.033) patients compared to data from the retrospective period regarding colonized (72/188 patients) and infected (9/188 patients) patients. There was a decrease in the average number of patient-days (from 343.72 to 292.44 days per months), though this difference is not significant (P=0.058). During the prospective period, indirect hand hygiene compliance showed a significant increase (from the previous 26.02 to 33.6 hand hygiene procedures per patient per hospital day, P<0.001). Conclusion: Colonizations and infections were rolled back successfully in a multi-step effort that required an interdisciplinary approach.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalWorld Journal of Pediatrics
DOIs
Publication statusAccepted/In press - Nov 23 2016

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Neonatal Intensive Care Units
beta-Lactamases
Bacteria
Hand Hygiene
Enterobacter
Klebsiella pneumoniae
Gram-Negative Bacteria
Newborn Infant
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Successful elimination of extended-spectrum beta-lactamase (ESBL)-producing nosocomial bacteria at a neonatal intensive care unit. / Szél, Borbála; Reiger, Zsolt; Urbán, E.; Lázár, Andrea; Mader, Krisztina; Damjanova, Ivelina; Nagy, Kamilla; Tálosi, Gyula.

In: World Journal of Pediatrics, 23.11.2016, p. 1-7.

Research output: Contribution to journalArticle

Szél, Borbála ; Reiger, Zsolt ; Urbán, E. ; Lázár, Andrea ; Mader, Krisztina ; Damjanova, Ivelina ; Nagy, Kamilla ; Tálosi, Gyula. / Successful elimination of extended-spectrum beta-lactamase (ESBL)-producing nosocomial bacteria at a neonatal intensive care unit. In: World Journal of Pediatrics. 2016 ; pp. 1-7.
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AU - Lázár, Andrea

AU - Mader, Krisztina

AU - Damjanova, Ivelina

AU - Nagy, Kamilla

AU - Tálosi, Gyula

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