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Abstract
Background
We noticed a sudden increase in the isolation of Klebsiella oxytoca from bronchial washing specimens during May to June 2006. An epidemiological investigation was conducted to identify the cause of the outbreak and to implement appropriate infection control measures.
Methods
A total of 18 isolates of K. oxytoca were found. The 14 bronchial washing specimens that yielded K. oxytoca were taken in the outpatient bronchoscopy suite, and the other 4 specimens were obtained by a portable bronchoscopy. The medical records and microbiologic findings of these patients were reviewed. Environmental samples from two bron-choscopes and the bronchoscopy suite were cultured. The relations between the available 10 isolates from bronchial washing fluid were investigated by pulsed-field gel electrophoresis (PFGE).
Results
No patients were judged to have had true infections attributable to K. oxytoca either before or after bronchoscopy. Cultures of samples from two bronchoscopes and related environment did not grow K. oxytoca. The PFGE analysis showed that 8 of 10 isolates had a similar pattern of DNA fragments. An infection control strategy was implemented, including adequately cleaning and disinfecting the broncho-scopes, and a sharp reduction in the incidence of K. oxytoca from bronchial washing samples followed.
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Fig. 2.
Epidemic curve of K. oxytoca isolates from bronchial washing samples collected during May and June. Solid bars, number of isolates related to the outbreak determined by PFGE analysis; striped bars, number of isolates unrelated to the outbreak determined by PFGE; open bars, number of isolates unavailable for PFGE.
Table 1.
Patient characteristics and the dates of the bronchial washing cultures that grew K. oxytoca
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