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Memorias del Instituto de Investigaciones en Ciencias de la Salud

On-line version ISSN 1812-9528


PEDROZO-TORRES, María Esther et al. Simultaneous outbreak of Pseudomonas Aeruginosa and ESBL producing-Klebsiella Pneumoniae in a Neonatal Intensive Care Unit of Asunción, Paraguay. Mem. Inst. Investig. Cienc. Salud [online]. 2019, vol.17, n.1, pp.59-68. ISSN 1812-9528.

Health care-associated infections (HCAI) constitute a serious public health problem. We describe an outbreak of HCAI in a Neonatal Intensive Care Unit (NUCI) in Asunción and the implemented control measures. This was a descriptive observational study of case series, performed between March 26th and April 18th, 2013. It is based on secondary data of the NICU, such as medical charts, nursing registries, death certificates, laboratory results and infection control registry forms. The study population consisted of 12 neonates. Pseudomona aeruginosa was isolated from biological samples of four neonates while ESBL producing-Klebsiella pneumoniae was isolated from other three patients. The patients were predominantly male (6/7), the average age was 2 days (range: 2-45 days), mostly premature babies (5/7). Invasive procedures were present in all cases. The overall attack rate was 58% (7/12), with an attack rate for P. aeruginosa of 33% (4/12) and for ESBL producing-K. Pneumoniae of 38% (3/12). Overall mortality was 29% (2/12) and the lethality rate attributable to P. aeruginosa infection was 50% (2/4). Measures implemented to control the outbreak were isolation of infected patients, one nurse per patient, intensified biosafety of invasive procedures strict control on proper hand washing, and interruption of patient transfers from other hospital during the outbreak. There were two simultaneous outbreaks with two different ethological agents, P. aeruginosa and ESBL producing-K. Pneumoniae. It is necessary to reinforce infection control measures and correct hand washing, in order to prevent outbreaks of HCAI in the NICU.

Keywords : outbreak; nosocomial infections; newborns; intensive care units; Pseudomonas; Klebsiella; Paraguay.

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