Epidemiological investigation and control effect of a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae infection in neurosurgical ICU
Objective To investigate the epidemiological characteristics and evaluate the prevention and control effect of a suspected healthcare-associated infection(HAI)outbreak caused by carbapenem resistant Klebsiella pneumoniae(CRKP)in a neurosurgery intensive care unit(ICU),so as to provide a reference for effective control of HAI.Methods Epidemiological and on-site environmental hygiene investigations were conducted on 3 cases of lower respiratory tract CRKP infection from March 16 to March 23,2023.The isolated strains of bacteria were identified and classified by PCR amplification of 16SrRNA,and homology comparison and genetic evolution analysis were performed.The implementation rates of various epidemic prevention measures before and after intervention were compared,and the intervention effect was also evaluated.Results The HAI rate of CRKP in the neurosurgery ICU from March 16 to 23,2023 was 5.88%.Four strains of CRKP were isolated from environmental hygiene samples.The second-generation metagenomic technology showed that Klebsiella pneumoniae was the absolute dominant bacterial group.The MLST typing analysis results showed that all 7 strains belonged to the same ST11 sequence typing,confirming the homology of the outbreak strains.After implementing a series of control strategies,there were no new cases of CRKP within next 3 months,and the epidemic was effectively controlled.Conclusion This suspected outbreak of infection might be related to inadequate implementation of contact isolation,inadequate hand hygiene,and a reduction in the number of cleaning staff,etc.Timely identification and investigation of the causes and targeted prevention and control measures are the key to effectively control the outbreak of CRKP nosocomial infection.
neurosurgeryintensive care unitcarbapenem-resistant Klebsiella pneumoniaenosocomial infectionsuspected outbreakmolecular epidemiological investigation
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