Reviewed by Shipra Gupta, MD, MS, Children’s Hospital at Montefiore
Bottomline– A single ESBL-producing E. coli strain caused a severe NEC outbreak via vertical and horizontal transmission, emphasizing the need for genomic monitoring and strengthened infection control in NICUs.
A necrotizing enterocolitis (NEC) outbreak in a Belgian NICU was caused by a rare, highly virulent, ESBL-producing Escherichia coli (O6:H1, ST73). Over one month, six preterm infants were colonized; four developed severe NEC, leading to one death and three cases of short bowel syndrome. Genomic analysis showed a unique ExPEC/UPEC strain carrying multiple virulence and resistance genes, including blaCTX-M-15. Transmission began vertically from a colonized mother in the index patient and spread horizontally via caregivers. Strict infection control—hand hygiene, isolation, and staff education—contained the outbreak.
Whole-genome sequencing enabled rapid identification, underscoring the value of maternal screening and genomic surveillance in preventing neonatal outbreaks.
Reference :
Despineux C, et al. Molecular Characterization of a Rare ESBL E. coli Strain Causing a Necrotizing Enterocolitis Outbreak in Preterm Infants. PIDJ. 2025. https://pubmed.ncbi.nlm.nih.gov/40472237