Abstract
BACKGROUND: We describe an outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) nosocomial infection in the intensive care unit (ICU) of a cancer hospital. We evaluate the containment measures implemented and provide evidence-based recommendations for improving CRKP infection prevention and control strategies. METHODS: Between June and July 2023, a comprehensive epidemiological investigation was conducted, including environmental hygiene surveillance and targeted infection control interventions. These measures focused on patients with CRKP nosocomial infections in the ICU, and their effectiveness was systematically evaluated. RESULTS: A total of 22 CRKP strains were identified in 14 patients(including one transferred from another hospital), with 13 nosocomial infections. Five patients had infections at multiple sites. The nosocomial infection rate was 8.1%, representing a statistically significant increase compared to the same period in previous years. Environmental surveillance detected CRKP contamination on the hands of two doctors (8.7% detection rate) and on various surfaces (8% detection rate), particularly shared equipment, bed unit surfaces, and sanitary ware. Following the implementation of control measures, the spread was effectively contained. CONCLUSIONS: Key factors contributing to transmission likely included delayed identification of infected patients, inadequate enforcement of isolation protocols, and suboptimal environmental cleaning and disinfection. Early detection, strict isolation measures, and thorough environmental cleaning are essential for effective prevention and control of CRKP in the ICU setting.