Phased outbreak of Burkholderia cepacia complex and multi-drug resistant Klebsiella pneumoniae causing neonatal sepsis in a tertiary hospital in Benin City, Nigeria: Investigation and mitigation

Ibadin, Ephraim Ehidiamen; Igunma, Jeremiah Agbons; Ogboghodor, Esohe Olivia; Okonkwo, Ikechukwu R; Ehinze, Ewere Scholar; Irabor, Philomena O; Eriamiatoe, Richard Etinosa; Idemudia, Ebenovbe

doi:10.21608/mid.2024.255175.1713

	Phased outbreak of Burkholderia cepacia complex and multi-drug resistant Klebsiella pneumoniae causing neonatal sepsis in a tertiary hospital in Benin City, Nigeria: Investigation and mitigation
Microbes and Infectious Diseases
Article 24, Volume 5, Issue 4, November 2024, Page 1486-1493 PDF (664.75 K)
Document Type: Original Article
DOI: 10.21608/mid.2024.255175.1713
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Authors
Ephraim Ehidiamen Ibadin ¹^{, 2}; Jeremiah Agbons Igunma²^{, 3}; Esohe Olivia Ogboghodor ⁴; Ikechukwu R Okonkwo⁵; Ewere Scholar Ehinze²^{, 4}; Philomena O Irabor²^{, 4}; Richard Etinosa Eriamiatoe¹; Ebenovbe Idemudia⁵
¹Medical Microbiology Division, Medical Laboratory Services, University of Benin Teaching Hospital, Benin City, Nigeria
²Infection Prevention and Control Committee, University of Benin Teaching Hospital, Benin City, Nigeria
³Medical Microbiology Department, University of Benin Teaching Hospital, Benin City, Nigeria
⁴Department of Public health and Community Medicine, University of Benin Teaching Hospital, Nigeria
⁵Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria
Abstract
Background: Burkholderia cepacia complex (Bcc) is an emerging pathogen known to contaminate pharmaceutical solutions and medical devices, but has largely been underreported as causing infections in Nigeria. This study presents detailed microbiological and environmental surveillance activities of a sequential outbreak of Bcc and extended-spectrum beta-lactamase (ESßL)-producing Klebsiella pneumoniae causing neonatal sepsis in a tertiary hospital in Benin City, Nigeria. Methods: Blood culture requests were made for neonates upon clinical suspicion of sepsis. Blood specimens were collected in duplicates in BactT/Alert bottles and incubated in the BacT/Alert machine. Further processing of culture-positive bottles was carried out. Identification and antimicrobial susceptibility tests (AST) of emergent organisms were carried out using the VITEK-2 COMPACT system. Environmental surveillance was also done following standard guidelines. Results: During the study period, a total of 303 blood culture requests were received out of which 101 (33.3%) yielded growth of Gram-negative bacilli. Thirty-three (10.9%) yielded Bcc and 41(13.7%) yielded K. pneumoniae (ESßL-producing). All Bcc isolates had similar AST patterns. Various samples from the medical solutions, disinfectants, and environment were negative for the Bcc and K. pneumoniae. However, Bcc and K. pneumoniae (ESßL-producing) were recovered from tap heads and sink drains. Timely infection prevention and control (IPC) interventions led to a decline in the incidence rate. Conclusion: An interplay of proper microbial identification, keen observation, and inter-professional collaboration was key in detailing the phased outbreak of Bcc and K. pneumoniae causing neonatal sepsis. The study highlights the significance of IPC measures in preventing and mitigating the spread of multidrug resistant pathogens.
Keywords
Burkholderia cepacia complex; outbreak; neonatal sepsis; Klebsiella pneumoniae


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