Outbreak ofmulti drug resistant klebsiella sp. in neonatal intensive care unit in a tertiary care hospital of Western Rajasthan

The incidence of nosocomial infections in the intensive care unit (ICU) is about 2 to 5 times higher than in the general in-patient hospital population. Endemic health-care-associated infection represents a major burden and safety issue for patients in the developing world. Infection with Klebsiella was not very uncommon in the Neonatal Intensive Care Units(NICU) at present. In this study we report an outbreak of MDR Klebsiella infection and its successful control in a tertiary care teaching hospital Jodhpur between November 2016 and January 2017. MDR Klebsiella were isolated and identified conventionally following Clinical and Laboratory Standards Institute (CLSI) guidelines, from various clinical specimens, sent from the NICU. Subsequently, infection control measures including isolation of infected babies, maintenance of hand hygiene, screening for colonization, treatment of infected as well as carrier were implemented in NICU. Demographic data were collected from clinical records. Three (3) care givers were found to be colonized with MDR Klebsiella strains. Antibiogram pattern of 20 infected babies matched with the MDR Klebsiella strains isolated from the colonized attendant and nursing staff. Prematurity, low birth weight and top feeding were established risk factors for infection with MDR in this study. Following control measures no such isolate were reported thereafter no case of MDR was reported. MDR outbreak acted as an alarm to the infection control committee of this tertiary care center of Western Rajasthan, India for continuous monitoring and screening for MDR isolates in NICU.