scholarly journals Nosocomial Transmission of Congenital Tuberculosis in a Neonatal Intensive Care Unit

2004 ◽  
Vol 39 (11) ◽  
pp. 1719-1723 ◽  
Author(s):  
Maryanne Crockett ◽  
Susan M. King ◽  
Ian Kitai ◽  
Frances Jamieson ◽  
Susan Richardson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Nosocomial Transmission ◽  
Congenital Tuberculosis

Congenital Tuberculosis and Management of Exposures in a Neonatal Intensive Care Unit

2002 ◽  
Vol 23 (10) ◽  
pp. 573-579 ◽  
Author(s):  
Brent W. Laartz ◽  
Hugo J. Narvarte ◽  
Douglas Holt ◽  
Julie A. Larkin ◽  
William F. Pomputius
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Chest Radiographs ◽  
Skin Tests ◽  
Base Line ◽  
Urban Hospital ◽  
Congenital Tuberculosis

Objective:We report a case of congenital tuberculosis in a neonatal intensive care unit (NICU) and the management of exposure to other neonates in the hospital. We review the literature regarding congenital tuberculosis and management of exposures in the NICU.Design:Case report and a survey of exposures with a 3-month follow-up.Setting:Urban hospital.Patients:Neonates exposed to a case of congenital tuberculosis.Interventions:Exposure to tuberculosis was treated with isoniazid. Purified protein derivative tests were placed at base-line and 3 to 4 months after exposure. Chest radiographs were performed if clinically indicated.Results:Congenital tuberculosis was diagnosed in our patient at 21 days of age during a prolonged hospital course. After initiation of anti-tuberculous medications, the patient gradually recovered from his illness. While he was treated in the NICU, there were 37 potentially exposed infants. Of these, 36 were administered tuberculin skin tests (average age, 1.7 months), all of which were read as 0 mm of induration. Of those 37, 35 began prophylaxis with isoniazid, and 30 were able to complete treatment with a minimum of 3 months of isoniazid therapy. Of those 30, two infants received 6 months of therapy. Additionally, 29 of the 37 infants had chest radiographs, none of which showed suspicious infiltrates or adenopathy. Finally, 30 of the 36 infants had repeat tuberculin skin tests at 3 months, all of which were read as 0 mm of induration (average age, 3.7 months).Conclusion:Congenital tuberculosis is an uncommon disease that requires early diagnosis for successful therapy and vigilant follow-up of potential exposures in the NICU. (Infect Control Hosp Epidemiol 2002;23:573-579).

scholarly journals Surveillance-embedded genomic outbreak resolution of methicillin-susceptibleStaphylococcus aureusin a neonatal intensive care unit

2019 ◽  
Author(s):  
AJH Cremers ◽  
JPM Coolen ◽  
CP Bleeker-Rovers ◽  
ADJ van der Geest-Blankert ◽  
D Haverkate ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Variable Number Tandem Repeat ◽  
Genomic Analysis ◽  
Nosocomial Transmission ◽  
Background Population ◽  
Depth Analysis ◽  
Mlva Typing

AbstractBackgroundWe observed an increase in methicillin-susceptibleStaphylococcus aureus(MSSA) infections among neonates at a Dutch third level neonatal intensive care unit. Weekly surveillance data of MSSA carriage among neonates and cross-sectional screenings of health care workers (HCWs) were available for outbreak tracing. While traditional typing of MSSA isolates by staphylococcal protein A gene (spatyping) and Multiple-Locus Variable number tandem repeat Analysis (MLVA) suggested that nosocomial transmission had contributed to the infections, here they lacked the resolution to draw solid conclusions.MethodsMSSA isolates from neonatal infections, carriage surveillance, and HCWs were subjected to whole-genome sequencing and compared by a series of automated tools includingde novoassembly, identification and localization of high-quality single nucleotide polymorphisms, and in-depth analysis of subsets of isolates. Outbreaks were defined as isolates that were more closely related than was to be expected from the genetic diversity in background surveillance.ResultsGenomic analysis identified isolates that had been unjustly assigned to clusters based on MLVA typing, whilespatyping was concordant but of insufficient resolution. Detailing particular subsets of isolates further improved resolution and although it provided evidence that HCWs were involved in multiple outbreaks, it alleviated heavy concerns about one particular HCW. Genomic clustering of isolates based on deviations from background surveillance matched epidemiological patient linkage. Compared to MLVA typing, the genomic analysis demonstrated more, shorter, and re-assorted nosocomial transmission chains during this outbreak.ConclusionsIn this study the improved resolution and accuracy of genomic outbreak analyses compared tospatyping and MLVA substantially altered the view on outbreaks, along with apposite outbreak measures. Inclusion of the circulating background population has the potential to overcome current issues in genomic outbreak inference.

Sign in / Sign up

Export Citation Format

Share Document