Since September, the Mexican Social Security Institute (IMSS) has been embroiled in investigations related to the tragic deaths of newborns treated in two of its neonatal intensive care units (NICUs), one located in Durango and the other in Guadalajara. In several instances, the presence of Klebsiella pneumoniae, a bacterium known to cause severe infections, was detected, while some families in Guadalajara also reported the presence of the fungus Candida albicans.
In Durango, five newborns succumbed after being admitted to the NICU at the General Hospital of Zone No. 1, with four testing positive for Klebsiella pneumoniae. In Guadalajara, reports indicate at least eleven families lost their children following care at the National Medical Centre of the West, with the IMSS acknowledging six deaths where infection was listed among the causes. Thus far, no health authority has confirmed an epidemiological link between the incidents at the two hospitals.
Tragic Events in Durango
Between September 1 and 19, eleven critically ill newborns were treated in the NICU. Six were discharged, but five tragically passed away within a mere five days. Three fatalities occurred on September 15, another on the 18th, and the last on the 19th. Upon publicly confirming the deaths, the IMSS announced it was undertaking a clinical and epidemiological review within the unit.
The fifth infant that died tested negative for Klebsiella pneumoniae, as did the six surviving newborns. Although the bacterium was found in the other four deceased infants, investigations are ongoing to determine its potential role in their deaths.
In response to the fatalities, the IMSS temporarily closed the NICU to new admissions and initiated environmental cultures and other surveillance measures. The Durango State Commission for the Protection against Health Risks also collected samples from other areas of the hospital, including operating rooms, since two of the newborns had undergone surgical procedures. Furthermore, they requested cleaning and maintenance logs to assess the state of the facilities.
By the time external sampling commenced, the NICU had already undergone a thorough cleaning. Subsequently, the IMSS reported that environmental cultures conducted in the unit did not detect Klebsiella. Simultaneously, samples from the patients were sent to Mexico City for genetic sequencing to ascertain any connection between the identified bacteria.
Legal Proceedings and Changes in Leadership
The investigation has also taken a legal turn, with families approaching the Attorney General’s Office to demand an inquiry into the treatment their children received. On October 6, the families’ attorney revealed that exhumations had been conducted for necropsies, although the specific number of bodies examined was not disclosed.
Following these developments, Roxana Blanca Rivera Leaños was removed from her position as head of the IMSS in Durango, with Saúl Nevárez Jiménez stepping in. In an official communication, the Institute highlighted the new director’s priorities, including addressing concerns raised by the affected families, implementing new measures in the NICUs, and collaborating with ongoing investigations.
Understanding the Risks of Klebsiella and Candida
Klebsiella is a type of bacteria typically found in human faeces without causing harm; however, certain strains can lead to infections when they invade other parts of the body. According to the Centres for Disease Control and Prevention (CDC), it can result in pneumonia, meningitis, and infections in the bloodstream, wounds, or surgical sites. The risk is heightened among hospitalised patients requiring ventilators or intravenous catheters, as well as those undergoing prolonged antibiotic treatments.
This bacterium primarily spreads through person-to-person contact but can also be transmitted via contaminated equipment, such as ventilators and catheters. Some variants have developed resistance to various antibiotics, complicating treatment options. The CDC further states that Klebsiella is not airborne.
On the other hand, Candida albicans is a fungus that can reside on the skin and within the body without causing illness. Problems arise when it proliferates uncontrollably, potentially entering the bloodstream or internal organs in severe cases. The CDC notes that the risk of invasive candidiasis increases among hospitalised patients, especially those using central venous catheters, receiving certain antibiotics, or born prematurely.
Investigating the Guadalajara Cases
One case that came to light in late September involved Anthony Jassiel, who was born on June 16, admitted for an intestinal issue, and sadly passed away on July 7. His mother reported that during his stay in the NICU at the Gynaecology and Obstetrics Hospital of the National Medical Centre of the West, she was informed that he had Klebsiella pneumoniae, while his death certificate also mentioned Candida albicans. The family had lodged a complaint with the IMSS as early as August 13, well before their story gained public attention.
Anthony was not alone; other parents began to voice their concerns. In the hospital’s waiting area, his family connected with the parents of Elián and José Nayib, whose children had also been hospitalised for weeks. Through their discussions, they identified similarities in the situations of the three newborns and organised to raise awareness of their cases.
Amid these concerns, allegations regarding the conditions within the NICU surfaced. Families claimed to have witnessed staff entering without gowns or masks, using mobile phones, and attending to babies without washing their hands. Additionally, during a meeting, the area director allegedly acknowledged the presence of bacteria and fungi, stating that “the outbreak could be controlled in 20 days.”
Ongoing Investigations and Future Measures
Questions also arose regarding when health authorities were informed. On September 29, the Secretary of Health for Jalisco, Héctor Raúl Pérez Gómez, stated that his department was unaware of the complaint, explaining that hospitals must report any identified infection outbreaks associated with medical care immediately. Two days later, Zoé Robledo, the general director of the IMSS, admitted that outbreaks of hospital-associated infections had been detected and reported in that NICU throughout 2026, although the communication did not specify when each occurred or which authorities were notified.
As days passed, more families began to share their experiences. The earliest known case is that of Elías Miguel Escalante García, born on March 14 and who passed away 15 days later. The accounts collected thus far span fatalities that occurred between March and late September.
Future Steps and Comprehensive Review
In response to the complaints, the IMSS announced on October 2 the initiation of an Independent Clinical Audit to review the cases in Guadalajara. External specialists in neonatology, infectious diseases, and epidemiology will examine each record to determine if infections related to hospital care contributed to the deaths and whether there were avoidable lapses. On October 6, Zoé Robledo confirmed that the review was already underway.
While the audit is conducted, both the hospital director and the head of the NICU have been temporarily removed from their positions. The Epidemiological Diagnosis and Reference Institute (InDRE) will also analyse the identified microorganisms to trace the origins of the outbreaks and ascertain any connections among the various cases.
The investigation has extended to other neonatal units as well. The Ministry of Health has established an “Operational Command” to review all 77 NICUs operated by the IMSS throughout the country, starting with Jalisco. Inspections will encompass recorded infections, identified microorganisms, antibiotic usage, and practices such as hand hygiene, catheter care, cleaning protocols, as well as the quality of water and drainage systems, and staffing ratios per infant.
In Durango, the IMSS has indicated that similar measures will be implemented in the NICU at the General Hospital of Zone No. 1, and that collaboration with ongoing audits and investigations will continue. Consequently, the incidents occurring in both states have not only kept investigations regarding the fatalities open but have also prompted the Institute to thoroughly reassess the conditions of its neonatal units nationwide.