Outbreak of extended-spectrum β-lactamase-producing Escherichia coli transmitted through breast milk sharing in a neonatal intensive care unit

Summary Background Routine surveillance in a neonatal intensive care unit (NICU) showed an increased detection of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL- E. coli ) in August 2012, following nearly a year without detection. Aim To describe the investigation and interven...

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Bibliographic Details
Published in:The Journal of hospital infection 2016-01, Vol.92 (1), p.42-46
Main Authors: Nakamura, K, Kaneko, M, Abe, Y, Yamamoto, N, Mori, H, Yoshida, A, Ohashi, K, Miura, S, Yang, T.T, Momoi, N, Kanemitsu, K
Format: Article
Language:English
Subjects:
beta-Lactamases - secretion
Breast milk sharing
Case-Control Studies
Cross Infection - epidemiology
Cross Infection - transmission
Disease Outbreaks
Disease Transmission, Infectious
Electrophoresis, Gel, Pulsed-Field
Escherichia coli - classification
Escherichia coli - enzymology
Escherichia coli - genetics
Escherichia coli - isolation & purification
Escherichia coli Infections - epidemiology
Escherichia coli Infections - microbiology
Escherichia coli Infections - transmission
Extended-spectrum β-lactamase-producing E. coli
Female
Genotype
Humans
Infant, Newborn
Infectious Disease
Intensive Care Units, Neonatal
Male
Milk, Human - microbiology
Molecular Typing
Neonatal intensive care unit
Risk Factors
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Summary:Summary Background Routine surveillance in a neonatal intensive care unit (NICU) showed an increased detection of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL- E. coli ) in August 2012, following nearly a year without detection. Aim To describe the investigation and interventions by a hospital infection control team of an outbreak of ESBL- E. coli in a NICU. Methods Six neonates with positive cultures of ESBL- E. coli (five with respiratory colonization, one with a urinary tract infection), control infants who were negative for ESBL- E. coli during the study period, and mothers who donated their breast milk were included. A case–control study was performed to identify possible risk factors for positive ESBL- E. coli cultures and molecular typing of isolated strains by pulsed-field gel electrophoresis. Findings The odds ratio for ESBL- E. coli infection after receiving shared unpasteurized breast milk during the study period was 49.17 (95% confidence interval: 6.02–354.68; P  
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2015.05.002