Outbreak of extended-spectrum ß-lactamase-producing Escherichia coli transmitted through breast milk sharing in a neonatal intensive care unit.
J Hosp Infect
; 92(1): 42-6, 2016 Jan.
Article
in En
| MEDLINE
| ID: mdl-26238662
ABSTRACT
BACKGROUND:
Routine surveillance in a neonatal intensive care unit (NICU) showed an increased detection of extended-spectrum ß-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 < 0.05). The pulsed-field gel electrophoresis pattern showed that all strains were identical, and the same pathogen was detected in freshly expressed milk of a particular donor. After ceasing the breast milk sharing, the outbreak was successfully terminated.CONCLUSION:
This outbreak indicates that contamination of milk packs can result in transmission of a drug-resistant pathogen to newborn infants. Providers of human breast milk need to be aware of the necessity for low-temperature pasteurization and bacterial cultures, which should be conducted before and after freezing, before prescribing to infants.Key words
Full text:
1
Collection:
01-internacional
Topics:
Promover_ampliacao_atencao_especializada
Health context:
1_ASSA2030
/
2_ODS3
/
3_ND
Database:
MEDLINE
Main subject:
Beta-Lactamases
/
Disease Outbreaks
/
Disease Transmission, Infectious
/
Escherichia coli
/
Escherichia coli Infections
/
Milk, Human
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Newborn
Language:
En
Journal:
J Hosp Infect
Year:
2016
Document type:
Article