|Title:||Study of an Outbreak of Enterobacter Cloacae Sepsis in a Neonatal Intensive Care Unit: The Application of Epidemiologic Chromosome Profiling by Pulsed-Field Gel Electrophoresis||Authors:||LEE, PING-ING||Keywords:||GENOMIC RESTRICTION FRAGMENTS;NOSOCOMIAL ENTEROBACTER;DNA;INFECTION||Issue Date:||2002||Journal Volume:||v.30||Journal Issue:||n.7||Start page/Pages:||381-385||Source:||AMERICAN JOURNAL OF INFECTION CONTROL||Abstract:||
Objective: From October 1996 to March 1997, a cluster of II cases of neonatal sepsis caused by Enterobacter cloacae with similar antimicrobial susceptibility patterns occurred in a neonatal intensive care unit. This outbreak prompted an investigation. Method: Twelve isolates obtained from 6 neonatal patients who developed E cloacae sepsis during the outbreak were analyzed. Four E cloacae isolates from 2 preterm neonates without E cloacae infection on the same ward, and I isolate from the hands of a nurse, were also examined. No E cloacae were isolated from the environment . Bacterial DNA digested with XbaI or NotI was analyzed with pulsed-field gel electrophoresis. Result: Three distinct banding patterns were identified by pulsed-field gel electrophoresis. Of the 6 preterm infants with sepsis, strain I was identified in I, strain II in 2, a mixed infection of strains I and II in 2, and strain III was found in only I infant. An isolate from the hands of a nurse was identified as strain II, as were the 4 isolates from the 2 preterm neonates without E cloacae infection. Thus, this outbreak of sepsis was caused by 2 genotypes of E cloacae. Conclusion: This study demonstrates that pulsed-field gel electrophoresis with restriction enzyme digestion is a valuable tool for genetic characterization of multidrug- resistant E cloacae strains during outbreaks.
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