{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T06:33:06Z","timestamp":1772865186518,"version":"3.50.1"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":4203,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2003,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0195941700081583_abs1\"><jats:title>Objective:<\/jats:title><jats:p>To investigate the clinical, microbiological, and epidemiologic features of three outbreaks caused by<jats:italic>Klebsiella<\/jats:italic>during 3 years.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700081583_abs2\"><jats:title>Setting:<\/jats:title><jats:p>Neonatal intensive care unit of a university hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700081583_abs3\"><jats:title>Patients:<\/jats:title><jats:p>Thirty affected neonates.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700081583_abs4\"><jats:title>Methods:<\/jats:title><jats:p>Data were collected through chart reviews and conversations with physicians. Screening samples were obtained from the staff, the neonates, and the environment. Antibiogram typing and arbitrarily primed polymerase chain reaction-based fingerprinting were used to type the strains.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700081583_abs5\"><jats:title>Results:<\/jats:title><jats:p>The first outbreak had 13<jats:italic>K. pneumoniae<\/jats:italic>strains isolated. The second outbreak had 10<jats:italic>K. oxytoca<\/jats:italic>strains isolated. The third outbreak had 20<jats:italic>K. pneumoniae<\/jats:italic>strains isolated. More than half of the patients had low birth weights, were premature, and underwent mechanical ventilation and intravenous catheterization. Approximately three-fourths of the patients died. The isolates tested were completely susceptible to meropenem, cefoxitin, and ciprofloxacin and were resistant to cephalothin. More than half of these strains were resistant to many beta-lactam antibiotics, amikacin, and trimethoprim\/sul-famethoxazole. Typing procedures yielded 3 antibiotypes and 3 genotypes among the isolates of the first outbreak, 3 antibiotypes with 1 subtype and 2 genotypes with 1 subtype in the second outbreak, and 2 antibiotypes and 2 genotypes in the third outbreak.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700081583_abs6\"><jats:title>Conclusions:<\/jats:title><jats:p><jats:italic>Klebsiella<\/jats:italic>outbreaks mainly affected premature neonates with intravenous catheters, mechanical ventilation, or both. The high mortality rate (76.7%) was notable. Resistance to multiple antibiotics, but mainly to broad-spectrum beta-lactam antibiotics, was observed, particularly in<jats:italic>K. pneumoniae<\/jats:italic>isolates. Molecular typing indicated that the three outbreaks were not related to one other (<jats:italic>Infect Control Hosp Epidemiol<\/jats:italic>2003;24:495-500).<\/jats:p><\/jats:sec>","DOI":"10.1086\/502245","type":"journal-article","created":{"date-parts":[[2006,3,13]],"date-time":"2006-03-13T16:21:01Z","timestamp":1142266861000},"page":"495-500","source":"Crossref","is-referenced-by-count":32,"title":["Analysis of Three Outbreaks Due to<i>Klebsiella<\/i>Species in a Neonatal Intensive Care 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