TY - JOUR
T1 - Characterization of an outbreak due to extended-spectrum β-lactamase-producing Klebsiella pneumoniae in a pediatric intensive care unit transplant population
AU - Rebuck, Jill A.
AU - Olsen, Keith M.
AU - Fey, Paul D.
AU - Langnas, Alan N.
AU - Rupp, Mark E.
PY - 2000
Y1 - 2000
N2 - Limited information exists regarding Klebsiella pneumoniae's production of an extended-spectrum β-lactamase (KP-ESBL) in pediatric patients, particularly solid-organ transplant recipients. This study characterized the microbiological, epidemiological, and clinical features of a KP-ESBL outbreak in children receiving a liver transplant, an intestinal transplant, or both. All children found to have microbiologically confirmed K. pneumoniae during a 21-month period were reviewed. ESBL production was defined by double-disk diffusion, and 6 distinct pulsed-field gel electrophoresis patterns were identified. Fifty-six percent of the transplant patients we studied developed KP-ESBL, representing 87% of all microbiologically confirmed cases at our institution. As compared with 16 control transplant patients who were negative for KP-ESBL, the 20 transplant patients who acquired KP-ESBL were younger (aged ≤5 years; 80.0% vs. 43.8%, P = .038) and experienced placement of ≥3 central venous catheters before recovery of the first K. pneumoniae isolate (73.7% vs. 18.8%, P = .002). This study suggests that children who receive liver or intestinal transplants are at high risk for KP-ESBL acquisition.
AB - Limited information exists regarding Klebsiella pneumoniae's production of an extended-spectrum β-lactamase (KP-ESBL) in pediatric patients, particularly solid-organ transplant recipients. This study characterized the microbiological, epidemiological, and clinical features of a KP-ESBL outbreak in children receiving a liver transplant, an intestinal transplant, or both. All children found to have microbiologically confirmed K. pneumoniae during a 21-month period were reviewed. ESBL production was defined by double-disk diffusion, and 6 distinct pulsed-field gel electrophoresis patterns were identified. Fifty-six percent of the transplant patients we studied developed KP-ESBL, representing 87% of all microbiologically confirmed cases at our institution. As compared with 16 control transplant patients who were negative for KP-ESBL, the 20 transplant patients who acquired KP-ESBL were younger (aged ≤5 years; 80.0% vs. 43.8%, P = .038) and experienced placement of ≥3 central venous catheters before recovery of the first K. pneumoniae isolate (73.7% vs. 18.8%, P = .002). This study suggests that children who receive liver or intestinal transplants are at high risk for KP-ESBL acquisition.
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U2 - 10.1086/317474
DO - 10.1086/317474
M3 - Article
C2 - 11096004
AN - SCOPUS:0034573401
VL - 31
SP - 1368
EP - 1372
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 6
ER -