Asymptomatic carriage of Klebsiella pneumoniae producing extended-spectrumbeta-lactamase by patients in a neurological early rehabilitation unit: Management of an outbreak

During 11 months 58 extended-spectrum beta -lactamase-producing Klebsiella pneumoniae (ESBL-Kp) isolates were grown from 10 patients on a neurological early rehabilitation unit. The patients had no signs of infection but were colonized in the nose and trachea, and unusually only one had colonization in the gut. A single clone of ESBL-Kp was identified by pulse field gel electrophoresis . Strong hygienic precautions similar to those for Methicillin-resistant St aphylococcus aureus patients prevented spread of the bacteria to other ward s. However, rehabilitation for patients with severe neurological failures m ade it very difficult to follow hygienic requirements. Disinfection of muco us membranes was difficult. Eventually the application of a nasal spray con taining povidone-iodine proved to be successful. (C) 2001 The Hospital Infe ction Society.