The Pediatric infectious disease journal
September 1, 2026 · via Europe PMC
Two Distinct Outbreaks of Extended-spectrum Beta-lactamase-producing Klebsiella Species in a Neonatal and Pediatric Intensive Care Unit in Switzerland.
Kirchner C, Werlen L, Guler C, Seiffert SN, Binz N, Egli A, Seth-Smith HMB, Cusini A
AI summary — for doctors, generated from the abstract only
Two ESBL Klebsiella outbreaks in a Swiss neonatal and pediatric ICU were clonal, with environmental reservoirs.
What was studied
Outbreak analysis with weekly screening, environmental sampling, short- and long-read sequencing.
Key findings
- K. michiganensis in 16.7% (19/114) screened patients and K. pneumoniae in 14.4% (17/118)
- Environmental isolates found (5 and 3 samples)
- WGS showed clonal clusters
Clinical relevance
Environmental reservoirs sustain NICU outbreaks.
Who should care
Limitations
Single unit; risk factor results are cut off.
Screen weekly and sample environment during NICU ESBL clusters.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND
Healthcare-associated infections caused by Klebsiella spp. are associated with substantial morbidity and mortality in neonatal and pediatric intensive care units. We describe 2 outbreaks of extended-spectrum beta-lactamase-producing Klebsiella michiganensis and Klebsiella pneumoniae in the same unit.
METHODS
Weekly screening for extended-spectrum beta-lactamase-producing Enterobacterales and environmental sampling were performed during outbreaks. Isolates were analyzed using whole genome sequencing (WGS; Illumina) and core genome multilocus sequence typing. Selected isolates underwent long-read sequencing (Oxford Nanopore Technology) to assess plasmid transmission. Risk factors for colonization in patients up to 1 month of age were evaluated using univariable and multivariable logistic regression.
RESULTS
During the first outbreak, K. michiganensis was detected in 16.7% (19/114) of screened patients and in 5 environmental samples. During the second outbreak, K. pneumoniae was identified in 14.4% (17/118) of patients and in 3 environmental samples. WGS demonstrated clonal clustering of the K. michiganensis isolates, belonging to ST-231, carrying blaCTX-M-9 and of the K. pneumoniae belonging to ST-469, carrying blaCTX-M-15. Hybrid genome assembly showed that blaCTX-M-carrying plasmids were unrelated, excluding plasmid-mediated transmission. In multivariable analysis, higher gestational age at birth was associated with lower odds of colonization, adjusted for antibiotic exposure, central venous catheter use, ventilation and pediatric index of mortality 2 score. Infection control interventions included reinforcement of standard precautions, sink disinfection and removal of a contaminated sink.
CONCLUSIONS
WGS elucidated outbreak transmission dynamics, identified environmental reservoirs, and excluded plasmid transmission, thereby informing targeted infection control measures. Low gestational age at birth was identified as a risk factor for colonization.
DOI
10.1097/INF.0000000000005386
PMID
42675583
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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