ArticleAntimicrobial resistance and infection control2013
Outbreak of colonizations by extended-spectrum β-lactamase-producing Escherichia coli sequence type 131 in a neonatal intensive care unit, Italy.
Article in Antimicrobial resistance and infection control, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Epidemic potential of Escherichia coli ST131 and Klebsiella pneumoniae ST258: a systematic review and meta-analysis.BMJ open · 2016Pooled it
- Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review.Systematic reviews · 2015Pooled it
- Prevalence of extended-spectrum β-lactamase and carbapenemase-producing Escherichia coli from patients, cattle, and environmental sources in northwest Amhara, Ethiopia: a one health approach.BMC microbiology · 2026Article
- Article
- Genomic Characterization of UropathogenicInternational journal of molecular sciences · 2023Article
- Molecular epidemiology and antimicrobial resistance phenotype of paediatric bloodstream infections caused by Gram-negative bacteria.Communications medicine · 2022Article
- Antimicrobial Activity of a Novel Cu(NOMaterials (Basel, Switzerland) · 2021Article
- Efficacy of a coordinated strategy for containment of multidrug-resistant Gram-negative bacteria carriage in a Neonatal Intensive Care Unit in the context of an active surveillance program.Antimicrobial resistance and infection control · 2021Article
- The first occurrence of a CTX-M ESBL-producing Escherichia coli outbreak mediated by mother to neonate transmission in an Irish neonatal intensive care unit.BMC infectious diseases · 2017Article
- Article
- Article
- Lethal neonatal meningoencephalitis caused by multi-drug resistant, highly virulent Escherichia coli.Infectious diseases (London, England) · 2016Article
- About the usefulness of contact precautions for carriers of extended-spectrum beta-lactamase-producing Escherichia coli.BMC infectious diseases · 2015Observational
- Escherichia coli ST131, an intriguing clonal group.Clinical microbiology reviews · 2014Review
- Successful control of a neonatal outbreak caused mainly by ST20 multidrug-resistant SHV-5-producing Klebsiella pneumoniae, Greece.BMC pediatrics · 2014Article
- Procalcitonin for antibiotic treatment in intensive care unit patients.Current infectious disease reports · 2013Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtended spectrum β-lactamases (ESBLs) often associated with resistance to aminoglycosides and fluoroquinolones have recently emerged in community-associated Escherichia coli. The worldwide clonal dissemination of E. coli sequence type (ST)131 is playing a prominent role.We describe an outbreak of colonizations by ESBL-producing E. coli (ESBL-E. coli) in the neonatal intensive care unit (NICU) of the University Hospital, Palermo, Italy.
methodsAn epidemiological investigation was conducted with the support of molecular typing. All children admitted to the NICU and colonized by ESBL-E. coli between January and June 2012, were included in the study. Cases were defined as infants colonized by E. coli resistant to third generation cephalosporins and fluoroquinolones. A case-control study was also performed to identify possible risk factors.
resultsDuring the outbreak period, 15 infants were found to be colonized by ESBL-E. coli. The epidemic strain demonstrated continuous transmission throughout the outbreak period. Case-control study identified a lower birth weight as the only risk factor for colonization. The strain belonged to the sequence-type 131 community-associated clone. Transmission control interventions, including contact precautions and cohorting, restriction of the new admissions, sanitization of surfaces and equipment and targeted training sessions of the NICU staff, were successful in interrupting the outbreak.
conclusionsAlthough invasive infections did not develop in any of the 15 colonized neonates, our report highlights the need to strictly monitor the spill in the NICU setting of multidrug resistant community-associated organisms. Our findings confirm also the role of active surveillance in detecting the silent spread of ESBL-producing Gram negatives in a critical healthcare setting and trigging the implementation of infection control measures. As β-lactam and fluoroquinolone resistant E. coli strains are increasingly spreading in the community, this event could become a more serious challenge.
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