Title : Outbreak of multi-drug resistant Klebsiella pneumoniae in a Tunisian university hospital
Abstract:
Introduction: Klebsiella pneumoniae is a gram-negative bacterium that has become a well-recognized cause of nosocomial infections. Hospital outbreaks due to multiresistant K.pneumoniae strains have been described throughout the world. We aimed to describe the occurrence of outbreak that were caused by KPC-producing Klebsiella pneumoniae, emphasizing the interventions that were implemented to contain the outbreak.
Methods: Following the alert given by an alert by the microbiology department, signaling the presence of five cases of positive cultures for Klebsiella Pneumoniae in four different departments; a team of the department of prevention and security of care made an investigation. A review of files was conducted to draw the synoptic table and the table of cases.
Results: In order to limit dissemination; first urgent measures taken were: all patients had undergone a septic isolation and their transfer to other units was stopped. Furthermore, a screening survey based on fecal swab screening among contact patients as well as healthcare staff; was implemented, and compliance with standard precautions measures such as hand hygiene and the wearing of protective equipment has been reinforced. The visit to the involved wards has allowed to draw the table of cases. In fact, we found that all patients were intubated and had a urinary catheter as well as a peripheral venous catheter were inserted. One patient presented COVID 19 pneumonia. It should be noted that all patients were undergoing multi-drug therapy. According to the collected information and the fact that patients were transferred between departments, the hypotheses of this outbreak origin is hand transmission.
Conclusion: Implementation of those urgent measures enabled us to control this outbreak. In fact, no other cases were reported. Continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of multi-drug resistant Klebsiella pneumonia.
