TY - JOUR AU - Lowe, Christopher AU - Willey, Barbara AU - O’Shaughnessy, Anna AU - Lee, Wayne AU - Lum, Ming AU - Pike, Karen AU - Larocque, Cindy AU - Dedier, Helen AU - Dales, Lorraine AU - Moore, Christine AU - McGeer, Allison T1 - Outbreak of Extended-Spectrum β-Lactamase–producing Klebsiella oxytoca Infections Associated with Contaminated Handwashing Sinks T2 - Emerging Infectious Disease journal PY - 2012 VL - 18 IS - 8 SP - 1242 SN - 1080-6059 AB - Klebsiella oxytoca is primarily a health care–associated pathogen acquired from environmental sources. During October 2006–March 2011, a total of 66 patients in a hospital in Toronto, Ontario, Canada, acquired class A extended-spectrum β-lactamase–producing K. oxytoca with 1 of 2 related pulsed-field gel electrophoresis patterns. New cases continued to occur despite reinforcement of infection control practices, prevalence screening, and contact precautions for colonized/infected patients. Cultures from handwashing sinks in the intensive care unit yielded K. oxytoca with identical pulsed-field gel electrophoresis patterns to cultures from the clinical cases. No infections occurred after implementation of sink cleaning 3×/day, sink drain modifications, and an antimicrobial stewardship program. In contrast, a cluster of 4 patients infected with K. oxytoca in a geographically distant medical ward without contaminated sinks was contained with implementation of active screening and contact precautions. Sinks should be considered potential reservoirs for clusters of infection caused by K. oxytoca. KW - Klebsiella oxytoca KW - outbreak KW - ICU KW - sink KW - extended-spectrum β-lactamase KW - ESBL KW - antimicrobial resistance KW - hand-washing KW - bacteria KW - handwashing KW - Canada DO - 10.3201/eid1808.111268 UR - https://wwwnc.cdc.gov/eid/article/18/8/11-1268_article ER - End of Reference