Extended-spectrum β-lactamase-producing Klebsiella pneumoniae in the neonatal intensive care unit: does vancomycin play a role?
DOI:10.1016/j.ajic.2013.09.028
Background:
Extended-spectrum
b
-lactamase (ESBL)-producing
Klebsiella
species cause worldwideproblems in neonatal intensive care units (NICUs). This study aimed to determine possible risk factors forinfection or colonization with ESBL-producing
Klebsiella pneumoniae
(ESBLKp) during an outbreak in theNICU.
Methods:
A retrospective cohort study was conducted among neonates admitted to the NICU of a teachinghospital in Riyadh, Saudi Arabia, during an outbreak of ESBLKp from April to July 2008. The incidencedensity ratio was calculated to determine possible predictors of ESBLKp colonization or infection.
Results:
During 2,265 person-days of follow-up of 118 neonates, 4 became infected, and 8 were colonizedwith ESBLKp. Univariate analyzes revealed that, among 14 neonates who were treated with vancomycin,9 (64.3%) developed infection or colonization with ESBLKp, whereas, among 104 neonates who were nottreated with vancomycin, 3 (2.9%) were affected, with an incidence density ratio of 4.22 (95% con
fi
denceinterval: 1.47-5.15). Parenteral feeding and mechanical ventilation were found to be marginally signi
fi
-cant risk factors.
Conclusion:
Treatment with vancomycin appears to be a risk factor for infection or colonization withESBLKp in the NICU setting
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