Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-26T10:45:12.266Z Has data issue: false hasContentIssue false
  • English
  • Français

Nosocomial klebsiellas: I. Colonization of hospitalized patients

Published online by Cambridge University Press:  15 May 2009

Michael L. Haverkorn  and
M. F. Michel
Michael L. Haverkorn
Affiliation:
Department of Clinical Microbiology and Antimicrobial Therapy, Medical Faculty, Erasmusuniversity, Rotterdam, The Netherlands
M. F. Michel
Affiliation:
Department of Clinical Microbiology and Antimicrobial Therapy, Medical Faculty, Erasmusuniversity, Rotterdam, The Netherlands
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The colonization of patients by Klebsiella and several other gram-negative bacteria was studied in a hospital urological ward over a period of six months. Before and during the survey there was no evidence of an outbreak of nosocomial infection and multi-drug resistant strains of Klebsiella were not isolated.

Klebsiella were biotyped by nine biochemical tests, which led to the detection of 66 biotypes spread uniformly throughout the survey period. This method of biotyping proved a useful epidemiological tool. The colonization rate of throats, hands, and faeces of patients increased after admission to the ward, especially when antibiotics were used. The effect of systemic antibiotics was greater than that of urinary antibiotics especially on throat and faeces carrier rates. Carrier rates for Klebsiella increased also after catheterization and operation – relationships which could well be multifactorial.

During the first two weeks after admission the proportion of antibiotic resistant strains of Klebsiella in carriers increased. The proportion of resistant strains amongst isolations from clinical infections was always greater than among strains isolated routinely from sites of carriage.

Type
Research Article
Information
Journal of Hygiene , Volume 82 , Issue 2 , April 1979 , pp. 177 - 193
Copyright
Copyright © Cambridge University Press 1979

References

REFERENCES

Alexander, J. W. (1973). Nosocomial infections. Current Problems in Surgery, August 1973, pp. 3–54.Google ScholarPubMed
Cowan, S. T., Steel, K. J., Shaw, C. & Duguid, J. P. (1960). A classification of the Klebsiella group. Journal of General Microbiology 23, 601–2.CrossRefGoogle ScholarPubMed
Cowan, S. T. & Steel, K. J. (1966). Manual for the Identification of Medical Bacteria. Cambridge University Press.Google Scholar
Cruickshank, R., Duguid, J. P., Marmion, B. P. & Swain, R. H. A. (1973). Medical Microbiology. Edinburgh: Churchill Livingstone.Google Scholar
Datta, N. (1971). R-factor in Escherichia coli. Annals of the New York Academy of Sciences 182, 59–64.CrossRefGoogle ScholarPubMed
Edwards, P. R. & Ewing, W. H. (1972). Identification of Enterobacteriaceae. Minneapolis: Burgess Publishing Company.Google Scholar
Eisenach, K. D., Reber, R. M., Eitzman, D. V. & Bear, H. (1972). Nosocomial infection due to Kanamycin-resistant (R)-factor-carrying enteric organisms in an intensive care nursery. Pediatrics 50, 395–402.CrossRefGoogle Scholar
Eller, C. & Edwards, F. F. (1968). Nitrogen-deficient medium in the differential isolation of Klebsiella and Enterobacter from feces. Applied Microbiology 16, 896–9.CrossRefGoogle ScholarPubMed
Finland, M. & McGowan, J. E. (1976). Nosocomial infections in surgical patients. Archives of Surgery 111, 143–5.CrossRefGoogle ScholarPubMed
Forbes, I., Gray, A., Hurse, A. & Pavillard, R. (1977). The emergence of Gentamicin-resistant Klebsiellae in a large general hospital. Medical Journal of Australia 1, 14–16.CrossRefGoogle Scholar
Goto, S. & Enomoto, S. (1970). Nalidixic acid cetrimide agar. A new selective plating medium for the selective isolation of Pseudomonas aeruginosa. Japanese Journal of Microbiology 14, 65–72.CrossRefGoogle Scholar
Hunt, T. K., Alexander, J. W., Burke, J. K. & MacLean, L. D. (1975). Antibiotics in surgery. Archives of Surgery 110, 148–55.CrossRefGoogle ScholarPubMed
Johanson, W. G., Pierse, A. K. & Sanford, J. P. (1969). Changing pharyngeal bacterial flora in hospitalized patients. New England Journal of Medicine 281, 1137–40.CrossRefGoogle Scholar
Lacey, R. W. (1975). A critical appraisal of the importance of R-factors in the Enterobacteriaceae in vivo. Journal of Antimicrobial Chemotherapy 1, 25–37.CrossRefGoogle ScholarPubMed
Martin, C. M., Ikari, N. S., Zimmerman, J. & Waitz, J. A. (1971). A virulent nosocomial Klebsiella with a transferable R-factor for Gentamicin: Emergence and suppression. The Journal of Infectious Diseases 124, S24–S29.CrossRefGoogle Scholar
McBride, M. E., Duncan, W. C. & Knox, J. M. (1977). The environment and the microbial ecology of human skin. Applied and Environmental Microbiology 33, 603–8.CrossRefGoogle ScholarPubMed
McGowan, J. E. & Finland, M. (1974). Infection and antibiotic usage at Boston City Hospital: Changes in prevalence during the decade 1964–1973. The Journal of Infectious Diseases 129, 421–8.CrossRefGoogle ScholarPubMed
Mouton, R. P., Glerum, J. H. & van Loenen, A. C. (1976). Relationship between antibiotic consumption and frequency of antibiotic resistance of four pathogens: A seven-year survey. Journal of Antimicrobial Chemotherapy 2, 9–19.CrossRefGoogle ScholarPubMed
Noriega, E. R., Leibowitz, R. E., Richmond, A. S., Rubinstrin, E., Schaefler, S., Simberkoff, M. S. & Rahal, J. J. (1975). Nosocomial infection caused by Gentamicinresistant Streptomycin-sensitive Klebsiella. Journal of Infectious Diseases 131, 545–550.CrossRefGoogle ScholarPubMed
Ørskow, T. (1955). The biochemical properties of Kiebsiella (Klebsiella aerogenes) strains. Acta pathologica et microbiologica scandinavica 37, 353–68.CrossRefGoogle Scholar
Price, D. J. E. & Sleigh, J. D. (1970). Control of infection due to Klebsiella aerogenes in a neurosurgical unit by withdrawal of all antibiotics. Lancet ii, 1213–5.CrossRefGoogle Scholar
Rennle, R. P. & Duncan, I. B. R. (1974). Combined biochemical and serological typing of clinical isolates of Kiebsiella. Applied Microbiology 28, 534–9.CrossRefGoogle Scholar
Richmond, A. S., Simberkoff, M. S., Rahal, J. J. & Schaefler, S. (1975). R-factors in Gentamicin-resistant organisms causing hospital infection. Lancet ii, 1176–8.CrossRefGoogle Scholar
Riser, E., Noone, P. & Bonnet, M. L. (1976). A new serotyping method for Klebsiella species: evaluation of the technique. Journal of Clinical Pathology 29, 305–8.CrossRefGoogle ScholarPubMed
Riser, E., Noone, P. & Poulton, T. A. (1976). A new serotyping method for Klebsiella species: development of the technique. Journal of Clinical Pathology 29, 296–304.CrossRefGoogle ScholarPubMed
Rose, H. D. & Schreier, J. (1968). The effect of hospitalization and antibiotic therapy on the gram-negative fecal flora. American Journal of the Medical Sciences 255, 228–36.CrossRefGoogle Scholar
Rose, H. D. & Babcock, J. B. (1975). Colonization of intensive care unit patients with gram-negative bacilli. American Journal of Epidemiology 101, 495–501.CrossRefGoogle ScholarPubMed
Rosenthal, S. & Tager, I. B. (1975). Prevalence of Gram-negative rods in the normal pharyngeal flora. Annals of Internal Medicine 83, 355–7.CrossRefGoogle ScholarPubMed
Selden, R., Lee, S., Wang, W. L. L., Bennett, J. V. & Eickhoff, T. C. (1971). Nosocomial Kiebsiella infections; intestinal colonization as a reservoir. Annals of Internal Medicine 74, 657–64.CrossRefGoogle Scholar
Sturtevant, A. B., Cassell, G. H., Bobo, R. A. & Feary, T. W. (1971). Effect of antibiotic treatment on the incidence of infectious drug resistance among intestinal lactose-fermenting bacteria isolated from burn patients. Infection and Immunity 3, 411–5.CrossRefGoogle ScholarPubMed