Klebsiella oxytoca is primarily a healthcare-associated pathogen acquired from environmental sources and should be on the radar of infection preventionists and environmental services professionals. Christopher Lowe, of the University of Toronto, and colleagues, report on an outbreak of class A extended-spectrum -lactamaseproducing K. oxytoca that occurred at a 472-bed, acute tertiary-care facility in Toronto.
Klebsiella oxytoca is an opportunistic pathogen that causes primarily hospital-acquired infections, most often involving immunocompromised patients or those requiring intensive care. Reported outbreaks have most frequently involved environmental sources. K. oxytoca, like other Enterobacteriaceae, may acquire extended-spectrum -lactamases (ESBL) and carbapenemases; outbreaks of multidrug-resistant K. oxytoca infection pose an increasing risk to hospitalized patients.
From October 2006 through March 2011, a total of 66 patients acquired K. oxytoca with one of two related pulsed-field gel electrophoresis patterns. Isolates were considered hospital acquired if the first specimen (clinical culture or rectal swab) yielding resistant K. oxytoca was obtained >3 days after the admission date or if the specimen was obtained <3 days after admission in a patient who had been hospitalized at the outbreak hospital within the previous three months. Patients were characterized as infected or colonized on the basis of National Healthcare Safety Network definitions.
New cases continued to occur despite reinforcement of infection control practices, prevalence screening, and contact precautions for colonized/infected patients. Cultures from handwashing sinks in the intensive care unit yielded K. oxytoca with identical pulsed-field gel electrophoresis patterns to cultures from the clinical cases. No infections occurred after implementation of sink cleaning three times daily, as well as sink drain modifications, and an antimicrobial stewardship program. In contrast, a cluster of four patients infected with K. oxytoca in a geographically distant medical ward without contaminated sinks was contained with implementation of active screening and contact precautions.
The researchers emphasize that sinks should be considered potential reservoirs for clusters of infection caused by K. oxytoca. Their research was published in the August 2012 issue of Emerging Infectious Diseases.
Reference: Lowe C, Willey B, et al. Outbreak of Extended-Spectrum -Lactamaseproducing Klebsiella oxytoca Infections Associated with Contaminated Handwashing Sinks. Vol. 18, No. 8. Emerg Infect Dis. August 2012.
The Role of Environmental Hygiene in Preventing Antimicrobial Resistance
March 19th 2024Uncover the pivotal role of environmental hygiene in thwarting antimicrobial resistance (AMR) for infection prevention teams. Learn how rigorous cleaning protocols and advanced technologies enhance patient safety and combat AMR.
COVID-19 Harmonization: Balancing Risks and Benefits of CDC's Latest Move
March 11th 2024The CDC's recent decision to align recommendations for respiratory viruses, particularly COVID-19, has garnered support from the public and infectious disease societies. However, as the Infectious Diseases Society of America (IDSA) lends its backing to the CDC's harmonization efforts, concerns persist regarding the implications of this shift, especially considering the Omicron variant's unique characteristics and the ongoing challenges posed by COVID-19's multi-system impacts.
Voices of Resilience: Q&A With the Editor of "Corona City: Voices From an Epicenter"
March 1st 2024Step into the diverse and poignant world of "Corona City: Voices From an Epicenter" with editor Lorraine Ash, MA. In this insightful Q&A, learn about the origins of this remarkable anthology, the challenges faced in capturing raw, unfiltered narratives of the COVID-19 pandemic, and the lasting impact of these stories on readers and communities alike.
Rare Disease Day 2024: Spotlight on Rare Infectious Diseases
February 29th 2024Rare Disease Day on February 29, 2024, shines a global light on the impact of rare diseases, including rare infectious diseases. With a focus on early diagnosis and treatment access, this day highlights the struggles of those with rare conditions.
COVID-19 Realities: Beyond a Respiratory Virus, Addressing Optimism in Pandemic Management
February 28th 2024A recent commentary by Dr. Amesh Adalja in MedPage Today challenges the perception of COVID-19 as solely a respiratory virus, highlighting its broader impact on the body. This analysis questions the notion that COVID-19 should be managed like common respiratory infections, urging a closer look at vaccine effectiveness, the rise of long COVID, and the need for enhanced measures to curb the virus's spread. Let's explore the complexities of COVID-19 management and the pressing realities faced by the US and the world.