{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:40:22Z","timestamp":1790685622061,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Premature newborns represent a vulnerable population, at high risk of acquiring nosocomial infections during neonatal intensive care unit (NICU) admission. Multidrug-resistant organisms represent the greatest concern due to their intrinsic virulence and the limited therapeutic options. Resistant Enterobacterales are a growing threat for critically ill neonates, with increasing numbers of NICU outbreaks caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales being described. This study reports the early detection and successful control of an outbreak caused by ESBL-producing Klebsiella pneumoniae (ESBL-KP) in an Italian NICU in February 2021. Results: A total of 13 newborns tested positive for ESBL-KP between 2\u20139 February 2021, of whom four (31%) had a bloodstream infection. Two were critically ill, extremely premature newborns who died because of multiple comorbidities, and two were cured after treatment with meropenem. All other patients survived and were either discharged home or moved to other hospitals\/wards in good clinical condition. ESBL-KP ST45 was found in all isolates by multilocus sequence typing (MLST) analysis. An outbreak control plan was set, including surveillance cultures for all neonates, NICU environments, and medical devices, along with the extended use of contact precautions and cohorting. In addition, the infection control plan was carried out through reinforcement and enhancement measures to guarantee maximal compliance. The outbreak was successfully controlled in seven days, given that no further cases were identified after 9 February. The source of the ESBL-KP outbreak was not identified through environmental sampling. Conclusions: Thanks to multidisciplinary management, a threatening outbreak of ESBL-KP in a NICU was controlled in few days. The prompt recognition of the event onset and the adoption of infection control interventions helped contain the bacteria spread on the ward.<\/jats:p>","DOI":"10.3390\/antibiotics11111649","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T03:31:10Z","timestamp":1668742270000},"page":"1649","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Successful Control of an Outbreak by Phenotypically Identified Extended-Spectrum Beta-Lactamase\u2013Producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit"],"prefix":"10.3390","volume":"11","author":[{"given":"Elena","family":"Priante","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit, Department of Women\u2019s and Children\u2019s Health, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3941-9952","authenticated-orcid":false,"given":"Chiara","family":"Minotti","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Department of Women\u2019s and Children\u2019s Health, University Hospital of Padua, 35128 Padova, Italy"},{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Contessa","sequence":"additional","affiliation":[{"name":"Department of Directional Hospital Management, University Hospital of Padua, 35128 Padova, Italy"},{"name":"Infection Control Division, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Boschetto","sequence":"additional","affiliation":[{"name":"Department of Directional Hospital Management, University Hospital of Padua, 35128 Padova, Italy"},{"name":"Infection Control Division, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Stano","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Dal Bello","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ettore","family":"De Canale","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Lolli","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Department of Women\u2019s and Children\u2019s Health, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6012-9453","authenticated-orcid":false,"given":"Vincenzo","family":"Baldo","sequence":"additional","affiliation":[{"name":"Infection Control Division, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Baraldi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Department of Women\u2019s and Children\u2019s Health, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7105-2105","authenticated-orcid":false,"given":"Daniele","family":"Don\u00e0","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University Hospital of Padua, 35128 Padova, Italy"},{"name":"Infection Control Division, University Hospital of Padua, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1085","DOI":"10.1542\/peds.2012-0145","article-title":"Committee on Fetus and Newborn, Committee on Infectious Diseases. 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