Columbia: Citrobacter freundii associated with deaths of infants at Seoul hospital

A Seoul, S. Korea hospital is investigating the deaths of 4 infants within the neonatal intensive care unit (NICU), based on the Korean Cdc (KCDC).

KoreaColumbia
Image/CIA

In mid-December, antibiotic resistant Citrobacter freundii was discovered in bloodstream cultures obtained from the 3 infants just before their deaths at the Ewha Womans College Mokdong Hospital, as well as their genetic sequence was discovered to be identical a few days later.

Not much later, KCDC announced the same bacteria was confirmed within the administered total parenteral diet (TPN) injections, that is provided to infants who find it difficult eating to supply necessary nutrients.

Five from 16 infants received the injections, leading to four deaths.

The injections were administered utilizing a central venous line, suggesting the chance that they were contaminated within their preparation.

“Combining the outcomes from the epidemiological analysis through the Korea Cdc and Prevention and individuals from the autopsies through the National Forensic Service, we’ve figured that the 4 newborns died of sepsis, brought on by contamination with Citrobacter freundii,” the Seoul Metropolitan Police Agency stated.

Law enforcement stated they’d book five medical employees on charges of involuntary wrongful death. The 2 nurses allegedly infringed around the duty of infection control while handling the injection of nutrient supplements. A chief nurse, a professional, as well as an attending physician apparently breached the job of guide and supervision of these two nurses.

Additionally, rotavirus was confirmed in ecological samples (incubator, blankets, etc.) in the NICU and samples from nine from the 12 infants. Eight from the nine infections had exactly the same genetic sequence (one pending). KCDC is carefully monitoring the health of the infants.

Related: 

Citrobacter freundii bacteria cultivated on a blood agar plate (BAP). Image/CDCCitrobacter freundii bacteria cultivated on the bloodstream agar plate (BAP).
Image/CDC

Rotavirus spike reported in Nsw and Queensland children

Government bodies in Nsw (NSW) and Queensland (Queensland) are reporting an increase in the amount of rotavirus cases being reported in youngsters under 5 years old.

The amount of people struggling with herpes, the most standard reason for severe gastroenteritis in youngsters and babies, is reaching levels not experienced within the last 5 years.

The organism's characteristic wheel-like appearance under the electron microscope gives the rotavirus its name from the Latin word 'rota,' meaning 'wheel.' Image/CDC/Jessica A. Allen/Alliza Eckerd.The organism’s characteristic wheel-like appearance underneath the electron microscope provides the rotavirus its name in the Latin word ‘rota,’ meaning ‘wheel.’
Image/CDC/Jessica A. Allen/Alliza Eckerd.

The reason behind the surge is unknown, leading medical officials to think about if the structure from the virus has altered, making people weaker into it. Dr Vicky Sheppeard, NSW Health’s director of communicable illnesses, confirmed these were investigating this.

“We have sent off samples towards the reference laboratories to find out if there’s a general change in the coding from the virus that’s also making people less safe from it.” she stated.

Nsw

The present outbreak in NSW may be the worst for 5 years with more than 1300 cases recorded by NSW Health in 2017, already greater than triple the 412 cases reported this past year.

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Children aged between 2 and four years old located in metropolitan Sydney would be the worst affected, with Sydney Children’s Hospital reporting between 5 and 6 occasions more hospitalisations in the virus compared to average years.

Queensland

In Queensland, it’s an identical story with more than 1527 recorded cases to date in 2017, greater than double the amount of cases in the past years.  Over 230 individuals have been hospitalized because of contracting herpes this season.

Since the development of the rotavirus vaccine in 2007, between 70% and 90% of Australian youngsters are vaccinated at two and 4 several weeks old.

The development of the vaccine seems to possess been successful. Before the vaccine, rotavirus was accountable for around 10,000 hospitalisations and 115,000 doctors visits each year. It has reduced by 70% because the vaccine was introduced.

However, the vaccine doesn’t offer full protection and wears off following a couple of years. The recommended mutation from the virus might also explain the current spike in figures.

Related: 

NSW medical officials report countless gastroenteritis cases in past week

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NSW Health is renewing calls to individuals struggling with gastroenteritis to remain home and follow medical health advice following a spate of outbreaks in aged care facilities and childcare centres.

The organism's characteristic wheel-like appearance under the electron microscope gives the rotavirus its name from the Latin word 'rota,' meaning 'wheel.' Image/CDC/Jessica A. Allen/Alliza Eckerd.The organism’s characteristic wheel-like appearance underneath the electron microscope provides the rotavirus its name in the Latin word ‘rota,’ meaning ‘wheel.’
Image/CDC/Jessica A. Allen/Alliza Eckerd.

There have been 39 outbreaks of gastroenteritis in institutions from 20-26 August, including 10 in aged care facilities, 22 in day care centres, five in hospitals and 2 in schools, affecting a minimum of 348 people.

This really is 120 percent greater, greater than double, compared to previous 5 year weekly average quantity of outbreaks for August.  

Dr Vicky Sheppeard, Director Communicable Illnesses, NSW Health, stated the outbreaks have been brought on by viral gastroenteritis including rotavirus and norovirus which spread easily for every person.

“Gastroenteritis is extremely infectious so it’s vital that individuals infected stay at home from work and sick children home from soccer practice or childcare not less than 24 hrs following the last signs and symptoms have stopped,” Dr Sheppeard stated.

“If your projects involves handling food or searching after children, the seniors or patients, don’t go back to work until 48 hrs after signs and symptoms have stopped.

“The best defence against gastroenteritis would be to wash both hands completely with soapy flowing water not less than ten seconds before handling and consuming food, after while using toilet, altering nappies or assisting somebody who has diarrhoea or vomiting.”

Signs and symptoms can include nausea, vomiting, diarrhoea, fever, abdominal discomfort, headache and muscle aches. They are able to take between one and 72 hours to build up in most cases last between 1 and 2 days, sometimes longer.

All children should receive rotavirus vaccine at six days and 4 several weeks old. This vaccine is about 70 percent good at stopping rotavirus infection, and also over 85 percent good at stopping severe gastroenteritis in infants. It’s likely to give protection for approximately 5 years. Rotavirus vaccine is free of charge for those children and provided with routine vaccines underneath the National Immunisation Program.

Those who are sick with gastroenteritis are encouraged to:

  • Avoid visiting hospitals or aged care facilities to avoid distributing herpes
  • Wash their hands with soapy flowing water not less than ten seconds after while using toilet and before touching food
  • Stay at home, rest and drink lots of fluids to ease lack of fluids
  • Go to a GP if signs and symptoms are severe or persistent.

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