Contact Isolation Guidelines for Klebsiella Pneumoniae

Core Contact Isolation Measures

All patients colonized or infected with Klebsiella pneumoniae, particularly carbapenem-resistant or carbapenemase-producing strains, should be placed on contact precautions with isolation in a single room to reduce transmission risk 1, 2
Healthcare workers must wear gloves and gowns before entering the room of patients colonized or infected with Klebsiella pneumoniae and remove these promptly after care, followed by hand hygiene 2, 3
Implement hand hygiene education programs using alcohol-based hand rubs before and after all patient contacts, with soap and water when hands are visibly soiled 2, 4
Isolate colonized and infected patients in single rooms whenever possible to reduce acquisition risk 2, 5
When single rooms are unavailable, cohort patients with the same multidrug-resistant Klebsiella pneumoniae strain in designated areas 5, 6
Consider cohorting staff to reduce transmission risk, particularly during outbreaks 5, 6
Use alert codes to promptly identify patients already known to be colonized at hospital/ward admission and implement pre-emptive contact precautions 2, 5

Establish a protocol to detect carbapenem resistance or carbapenemase production in Klebsiella species and immediately alert infection control staff 1, 7
Review microbiology records for the preceding 6-12 months to identify previously unrecognized cases 1, 7
Conduct point prevalence surveys in high-risk units (ICUs, units with previous cases, units with high antibiotic use) to identify additional colonized patients 1, 7
When a hospital-associated case is identified, perform active surveillance testing of patients with epidemiologic links to the case 1, 7
Surveillance screening should focus on rectal or perirectal swabs, which yield higher detection rates than other body sites 1, 7

Implement regular environmental cleaning procedures using appropriate detergents or disinfectants 2, 5
Dedicate non-critical medical equipment (stethoscopes, blood pressure cuffs) for use on individual patients colonized or infected with Klebsiella pneumoniae 2, 5
Ensure shared equipment is properly disinfected between patient use 2, 3
Consider environmental sampling of surfaces that have been in contact with colonized or infected patients during outbreaks 5, 6
Monitor cleaning performance to ensure consistent environmental decontamination 5, 6

Implement an antimicrobial stewardship program to limit the use of specific antimicrobial agents based on patient case-mix 2, 8
Conduct educational programs to ensure healthcare workers understand the epidemiological importance of Klebsiella pneumoniae and effective control measures 2, 4
Hold regular multidisciplinary meetings to implement interventions, review adherence, and provide feedback to staff 2, 4
Consider daily bathing of patients with chlorhexidine soap or chlorhexidine-impregnated cloths as part of a multifaceted approach during outbreaks 5, 6

Maintain contact precautions for the entire duration of hospitalization for patients with carbapenem-resistant Klebsiella pneumoniae 5, 6
For other multidrug-resistant Klebsiella strains, evidence on when to discontinue contact precautions is limited 5, 6

Inadequate communication when transferring patients between healthcare facilities can result in breaches of infection control 2, 5