The Vall d’Hebron in Barcelona isolates eight other neonates carrying the ‘Klebsiella
pneumonia ‘. The deceased suffered an intestinal ailment that was complicated in sepsis
Infection by the bacterium Klebsiella pneumonia has caused in the last week the death of two premature babies at the Vall d’Hebron hospital in Barcelona, which has also isolated the bacterium in eight other infants admitted to incubators, as explained yesterday afternoon. a health center in a press conference. The outbreak was announced hours earlier by the Association the Patient Advocate, who received a complaint from the father of one of the deceased.
The hospital wanted to send a message of tranquility about the state of the eight premature carriers since it assured that the bacteria did not cause them any disorder. “This number [in reference to the eight affected] does not have to alert us, what we have to warn is that [the bacteria] can cause an infection,” which has not happened so far, said Magda Campins, head of the service of Preventive Medicine of Vall d’Hebron.
The first deceased was a child “extremely premature” born on April 15 in the 24th week of gestation – the usual is between weeks 38 and 42-. The baby was born with 680 grams of weight and on the third day of life, he began to suffer symptoms of necrotizing enterocolitis, a serious intestinal disease common in premature children. The ailment consists of the inflammation of a part of the intestine that can cause the death of tissues and complicate with sepsis, as happened in this case. Those responsible for the hospital explained that “the usual treatment of advanced life support in the ICU and antibiotic was established, despite what died four days later”.
A girl born on April 16, also considered an “extremely premature” case, was the second deceased. Born in week 25 of pregnancy, her weight was just 485 grams. On this occasion, after six days of life, he began to show signs of enterocolitis and, despite receiving the same treatment, died two days later.
Subsequent analyses found “the bacteria klebsiella pneumonia resistant” to antibiotics in both babies. According to the Study of Prevalence of Nosocomial Infections in Spain (EPINE) of 2017, prepared by the Spanish Society of Preventive Medicine and true bible of hospital infections, this type of Klebsiella is the fourth most common bacterium in infections occurred in the centers Spanish health That year, it caused 7.96% of the infections identified in the 313 participating hospitals and more than 60,000 patients studied.
Campins explained that in the presence of a “multiresistant microorganism” the main measure is to isolate the affected babies in a single box, where they are treated by the same doctors to prevent the bacteria from spreading. In addition, surveillance measures are undertaken to other patients to verify that they remain free of the pathogen. As a reinforcement, environmental measures are adopted to ensure that the spaces and objects of the environment -from drains to containers- have not been colonized by bacteria either. Campins explained that the box in which the two deceased babies were “has been closed for new income” and that the outbreak has been reported to the Public Health Agency of Barcelona.
The center admitted that, as is usual in these outbreaks, the bacteria has passed from one baby to another because of the performance of health professionals, the so-called “cross-transmission”, instead of a common focus. As an example, Campins pointed out the use in several babies of objects that are not usually sterilized since they are of superficial use, like an ultrasound machine. All this material is now being analyzed, explained the center, which carries out routine bacterial analyzes in the Neonatology unit every three weeks.
On the death of the two neonates, the care director of the hospital, Rocío Cebrián, explained that the cause of the deaths was “the sum of several complications in patients so weak and of such extreme ages”. Cebrián recalled that the two deceased suffered from intestinal and respiratory symptoms that required mechanical ventilation.
The Department of Health of the Generalitat announced for its part the opening of an investigation on the outbreak. The Patient Advocate also reported that on Saturday he sent the information received from the father of one of the deceased to the Public Prosecutor’s Office of Barcelona, which has not yet ruled on the case.