Outbreak of late-onset group B Streptococcus in a neonatal intensive care unit

被引:35
作者
MacFarquhar, Jennifer K. [1 ,2 ]
Jones, Timothy F. [1 ,3 ]
Woron, Amy M. [4 ]
Kainer, Marion A. [1 ]
Whitney, Cynthia G. [5 ]
Beall, Bernard [5 ]
Schrag, Stephanie J. [5 ]
Schaffner, William [3 ]
机构
[1] Tennessee Dept Hlth, Communicable & Environm Dis Serv, Nashville, TN 37243 USA
[2] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Atlanta, GA USA
[3] Vanderbilt Univ, Sch Med, Dept Prevent Med, Nashville, TN 37212 USA
[4] Tennessee Dept Hlth Lab Serv, Nashville, TN USA
[5] Ctr Dis Control & Prevent, Resp Dis Branch, Atlanta, GA USA
关键词
Outbreak; late-onset group B Streptococcus; neonatal intensive care unit; NOSOCOMIAL TRANSMISSION; DISEASE; EPIDEMIOLOGY; INFECTIONS; SEPSIS; MENINGITIS; PREVENTION; EXPERIENCE; DIVERSITY; INFANTS;
D O I
10.1016/j.ajic.2009.08.011
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: In September 2007, the Tennessee Department of Health was notified of a cluster of late-onset group B streptococcal (GBS) infections in a neonatal intensive care unit (NICU). Outbreaks of late-onset GBS are rare. Methods: A case was defined as culture-confirmed invasive GBS infection in a neonate aged >= 7 days, identified in hospital A during August 23 to September 6, 2007. We reviewed medical records; examined NICU microbiology reports; and performed serotyping, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) on invasive isolates. Maternal GBS screening, prophylaxis, and infection control policies were reviewed and staff practices observed. Results: Five cases of late-onset GBS were identified. None of the mothers of the infants received optimal GBS prophylaxis. Patient isolates were of 2 serotypes, 3 PFGE patterns, and 2 MLST patterns. Three isolates were indistinguishable on subtyping. These 3 cases were clustered in time. No common health care providers were identified. Infection control deviations in the NICU were observed. Conclusion: We identified a multiclonal cluster of 5 late-onset GBS cases. Multiple factors likely contributed to the outbreak, including nosocomial transmission of GBS. Further efforts to prevent late-onset GBS disease are necessary.
引用
收藏
页码:283 / 288
页数:6
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