ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1557068
This article is part of the Research TopicOutbreak Investigations of Nosocomial InfectionsView all 16 articles
Containment of a Carbapenem-Resistant Klebsiella pneumoniae in an Intensive Care Unit during the COVID-19 pandemic
Provisionally accepted
- 1Department of Infection Control, The First Affiliated Hospital of Chongqing Medical University, chongqing, China
- 2Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Chongqing Medical University, Chongqing, Chongqing Municipality, China
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Background: A nosocomial outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) occurred in the 20-bed Respiratory Intensive Care Unit (RICU) of a tertiary teaching hospital during the COVID-19 pandemic (December 2022-February 2023). The outbreak was ultimately mitigated through multimodal infection control interventions aligned with WHO multidrug-resistant organism (MDRO) management guidelines. Methods: Following index case identification on 10 December 2022, a multidisciplinary outbreak response team implemented comprehensive control measures: Immediate geographic cohorting of CRKP-positive patients with dedicated staff; Enhanced contact precautions including daily chlorhexidine bathing; Tri-daily environmental decontamination using sporicidal agents; Mandatory hand hygiene audits with real-time feedback; Active surveillance through weekly rectal swabs for all RICU admissions. Environmental monitoring encompassed 120 high-touch surfaces sampled weekly.Results: Among 42 laboratory-confirmed CRKP cases, 85.7% (n=36) were identified through clinical specimens and 14.3% (n=6) via active surveillance. Post-outbreak surveillance revealed two imported CRKP cases detected through admission screening during the three-month follow-up period, both contained without secondary transmission. The increasing patient volume, prolonged use of personal protective equipment (PPE), and influx of new healthcare workers heightened the risk of CRKP transmission. Effective administrative guidance on nosocomial infections, behavioral control, active surveillance culture, environmental cleanliness and antimicrobial management are essential to prevent outbreak.Conclusions: This outbreak demonstrates the viability of containing CRKP transmission in resource-constrained pandemic settings through: rigorous adherence to contact precautions; prospective CRE active surveillance cultures. It is also need to implement antimicrobial stewardship programs in order to reduce the occurrence of microbial resistance.
Keywords: MDRO, CRKP, ICU Outbreak, Infection Control, COVID-19
Received: 08 Jan 2025; Accepted: 30 May 2025.
Copyright: © 2025 Li, Zhang, Wang and Qian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Keli Qian, Department of Infection Control, The First Affiliated Hospital of Chongqing Medical University, chongqing, China
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