Study of outbreak and risk factors associated with Klebsiella pneumoniae infection in a Neonatal Intensive Care Unit

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ID: 327380
2026
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Abstract
Abstract Background Klebsiella pneumoniae (Kp)​ is a​ Gram-negative bacillus​ commonly found ​​, present ​ the human gastrointestinal tract​. It has​​, with​ the ability to form biofilms, which ​gives ​​confers​​it​ a high pathogenic potential in hospital environments​.​​,​ ​A​​in a​ddition​ally, it possesses​ ​to having ​genetic resistance to various disinfectants and antibiotics, ​which makes​​making​ it a bacterium of global epidemiological relevance​ and​​, being ​one of the main pathogens associated with Healthcare Associated Infections (HAIs). Therefore, the identification, as well as the approach to outbreaks within the field of Hospital Epidemiology represents one of the most critical activities for the prevention and control of HAIs. Methods An observational, analytical, case-control, ambispective, outbreak study focused on the investigation of a nosocomial outbreak in the Neonatal Intensive Care Unit (NICU) of the HIMFG. Clinical and epidemiological characteristics were analyzed, as well as risk factors identified for all events through a comparative analysis (chi-square/Fisher statistical test). Pulsed-field gel electrophoresis (PFGE) was performed, as well as dendrogram with the method of grouping by Unweighted Pair-Group Method with Arithmetic averages (UPGMA). Results 6 cases and 15 controls matched by age and length of hospitalization were included. The median age was 50 days (SD=25.4, min 21, max 82 days). 100% had fever and 85% had tachycardia. The related factors were: invasive devices (percutaneous catheters p=0.032, OR=2.0), number of consultations (188 in the cases: surgery p=0.007, OR=2.76 and gastroenterology p<0.001, OR=2.2). Microbiological analyses showed the same agent isolated in patients and in an infusion pump from one case (evidencing the importance of Hand Hygiene (HH) to avoid horizontal transmission of microorganisms and subsequent HAIs). The PFGE demonstrated similarity of the band pattern between the strains associated with the outbreak. Conclusion This outbreak was eliminated through hard work and after the correction of the main factors identified: retraining in HH, improvement in the cleanliness of the clinical area, training in the implementation of percutaneous catheters, restriction of personnel entry, removal of unnecessary devices, among others.
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Authors Ortega Riosvelasco Fernando, Neria Rodríguez Andrea, Gutiérrez Morales Eduardo Carlos, Hernández Durán Eunice Yolanda, De Hoyos Godínez Lilia Amparo, López Marceliano Beatriz, Velázquez Guadarrama Norma, Padilla Sánchez Brenda Jossiean, Varela Espino Emidely, Campos Flores Susana, Pérez Campos Itzel Stella, Gamiño Arroyo Ana Estela, Guerrero Díaz Ana Carmen, Mejía Rosales Pedro Arturo
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Journal journal of the pediatric infectious diseases society
Year 2026
DOI
10.1093/jpids/piag070/piag070.031
URL
https://academic.oup.com/jpids/article-pdf/15/Supplement_2/S14/70833320/piag070.031.pdf
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