In this issue of The Journal, Cantey et al describe the occurrence and control of a nosocomial outbreak of multidrug-resistant Klebsiella pneumoniae infection/colonization in the neonatal intensive care unit (NICU) at Parkland Memorial Hospital, Dallas, Texas. Following septicemia of the index case and two additional fatal cases of infection within 48 hours, a multidisciplinary team (ie, medical, administrative, supportive, and environmental services) formulated a multidimensional control and investigation plan. Although single interventions were not studied, the rapid success of meticulous implementation of multiple standard infection control and prevention practices (eg, staffing, spacing, cohorting, auditing cleaning effectiveness, auditing hand hygiene beyond washing/gelling, frequent microbiologic screening of infants) stands as an example of “best practices.”This report is particularly useful because the outbreak occurred after good practices of antibiotic stewardship, including minimal use of broad-spectrum antibiotics and mitigation, without closing the NICU to new admissions or performing microbiologic sampling of healthcare personnel. In this issue of The Journal, Cantey et al describe the occurrence and control of a nosocomial outbreak of multidrug-resistant Klebsiella pneumoniae infection/colonization in the neonatal intensive care unit (NICU) at Parkland Memorial Hospital, Dallas, Texas. Following septicemia of the index case and two additional fatal cases of infection within 48 hours, a multidisciplinary team (ie, medical, administrative, supportive, and environmental services) formulated a multidimensional control and investigation plan. Although single interventions were not studied, the rapid success of meticulous implementation of multiple standard infection control and prevention practices (eg, staffing, spacing, cohorting, auditing cleaning effectiveness, auditing hand hygiene beyond washing/gelling, frequent microbiologic screening of infants) stands as an example of “best practices.” This report is particularly useful because the outbreak occurred after good practices of antibiotic stewardship, including minimal use of broad-spectrum antibiotics and mitigation, without closing the NICU to new admissions or performing microbiologic sampling of healthcare personnel. Prompt Control of an Outbreak Caused by Extended-Spectrum β-Lactamase–Producing Klebsiella pneumoniae in a Neonatal Intensive Care UnitThe Journal of PediatricsVol. 163Issue 3PreviewTo assess the effectiveness of a set of multidisciplinary interventions aimed at limiting patient-to-patient transmission of extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) during a neonatal intensive care unit (NICU) outbreak, and to identify risk factors associated with ESBL-KP colonization and disease in this setting. Full-Text PDF