NOSOCOMIAL COLONIZATION AND INFECTION CAU SED BY MULTIRESISTANT ENTEROBACTER-CLOACAE STRAINS IN A PEDIATRIC ONCOLOGY WARD

A multiresistant E. cloacae strain spread during a six month period in a paediatric oncology ward amongst nine children, who had different t umors and malformations. Three children who had shared a room were esp ecially affected. E. cloacae was isolated 122 times from the children with tumors and fivetimes from their environment. Specimens from which the bacteria were isolated, included blood cultures, catheter tips, w ound swabs, drains, skin and mucous membranes from most parts of the b ody. The majority of the E. cloacae strains were resistant to ampicill in, mezlocillin, piperacillin, azlocillin, doxycycline and cephalospor ins of the second and third generation and sensitive to imipenem, amin oglycosides and quinolones. The antimicrobial resistance patterns of t he E. cloacae strains from the paediatric oncology ward were compared to those isolated from other wards in the hospital. E. cloacae isolate s from the intensive care unit had a reduced sensitivity to beta-lacta m antibiotics, whereas the isolates from the other wards were, with th e exception of ampicillin, sensitive to beta-lactam antibiotics. The a nalysis of the E. cloacae strains from the paediatric oncology ward re vealed the same antimicrobial resistance pattern, bacteriocin type, RF LP-type and an identical enzyme and whole cell profile. Isolates from other wards showed considerable deviating patterns. The systematic reg istration and isolation of patients, colonized or infected with multir esistant E. cloacae strains, together with infection control methods, lead to a significant reduction in infections.