Gentamicin-Resistant Klebsiella Infections in a Neonatal Intensive Care Unit

Colonization of bacteria and infection of infants in intensive care nurseries continues to be one of the major causes of neonatal morbidity and mortality. The frequent use of penicillins and aminoglycosides in the treatment of such infants, however, has led to the emergence of multiple resistant organisms. Previous authors have noted serious neonatal infections with kanamycin-resistant organisms,¹,²while other reports have documented the increased prevalence hospital-wide of gentamicin-resistant organisms.³⁻⁵This report details an epidemic of gentamicin-resistantKlebsiellainfections in a neonatal intensive care unit that led to the death of three infants. Report of Cases.—The clinical setting of the epidemic was the Pediatric Special Care Unit (PSCU) of the Hospital of the Albert Einstein College of Medicine (HAECOM). Infants born at HAECOM, as well as those transferred, are cared for in the PSCU by the same medical and nursing staff. SeriousKlebsiellainfections developed in five infants