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The first occurence of a CTX-M ESBL-producing Escherichia coli outbreak mediated by mother to neonate transmission in an Irish neonatal intensive care unit.

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Show simple item record O'Connor, Ciara Philip, Roy K. Kelleher, John Powell, James O'Gorman, Alan Slevin, Barbara L. Woodford, Neil Turton, Jane F McGrath, Elaine Finnegan, Cathriona Power, Lorraine O'Connell, Nuala H. Dunne, Colum P. 2017-01-18T16:10:29Z 2017-01-18T16:10:29Z 2017
dc.description peer-reviewed en_US
dc.description.abstract Background: Escherichia coli (E. coli) comprise part of the normal vaginal microflora. Transfer from mother to neonate can occur during delivery resulting, sometimes, in neonatal bacterial disease. Here, we aim to report the first outbreak of CTX-M ESBL-producing E. coli with evidence of mother-to-neonate transmission in an Irish neonatal intensive care unit (NICU) followed by patient-to-patient transmission. Methods: Investigation including molecular typing was conducted. Infection was defined by clinical and laboratory criteria and requirement for antimicrobial therapy with or without positive blood cultures. Colonisation was determined by isolation without relevant symptoms or indicators of infection. Results: Index case was an 8-day-old baby born at 34 weeks gestation who developed ESBL-producing E. coli infections at multiple body sites. Screening confirmed their mother as colonised with ESBL-producing E. coli. Five other neonates, in the NICU simultaneously with the index case, also tested positive. Of these, four were colonised while one neonate developed sepsis, requiring antimicrobial therapy. The second infected neonate’s mother was also colonised by ESBL-producing E. coli. Isolates from all eight positive patients (6 neonates, 2 mothers) were compared using pulsed-field gel electrophoresis (PFGE). Two distinct ESBL-producing strains were implicated, with evidence of transmission between mothers and neonates for both strains. All isolates were confirmed as CTX-M ESBL-producers. There were no deaths associated with the outbreak. Conclusions: Resources were directed towards control interventions focused on hand hygiene and antimicrobial stewardship, which ultimately proved successful. Since this incident, all neonates admitted to the NICU have been screened for ESBL-producers and expectant mothers are screened at their first antenatal appointment. To date, there have been no further outbreaks. en_US
dc.language.iso eng en_US
dc.publisher BioMed Central en_US
dc.relation.ispartofseries BMC Infectious Diseases;17:16
dc.subject ESBL en_US
dc.subject outbreak en_US
dc.subject Escherichia coli en_US
dc.subject Ireland en_US
dc.subject CTX-M en_US
dc.subject NICU en_US
dc.title The first occurence of a CTX-M ESBL-producing Escherichia coli outbreak mediated by mother to neonate transmission in an Irish neonatal intensive care unit. en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US 2017-01-18T15:58:28Z
dc.description.version PUBLISHED
dc.identifier.doi 10.1186/s12879-016-2142-6
dc.contributor.sponsor Irish Society of Clinical Microbiologists en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 2693833
dc.internal.rssid 2698453
dc.internal.copyrightchecked Yes
dc.identifier.journaltitle Bmc Infectious Diseases
dc.description.status peer-reviewed

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