Successful management of an outbreak due to carbapenem-resistant Acinetobacter baumannii in a neonatal intensive care unit

Abstract

The investigation and successful management of a monoclonal Acinetobacter baumannii outbreak in a neonatal intensive care unit are described. Upon the first clustered carbapenem-resistant A. baumannii (CRAB) infections, a bundle of actions were taken, including enhanced infection control, active surveillance (weekly stool samples), casecontrol study, staff education, daily audits and discontinuation of new admissions. Between September and December 2011, eight neonates developed 10 CRAB infections (five blood, four respiratory and one eye). A total of 216 active surveillance cultures were obtained from 96 neonates (43 % had ≥2 samples). During weeks 12, 16 and 17, active surveillance detected 3, 1 and 2 new CRAB acquisitions, respectively. Prevalence of infections/colonizations decreased, and no event occurred after 20th week. A colonized neonate developed CRAB sepsis and died. All CRAB isolates harboured blaOXA-58 and the intrinsic chromosomal blaOXA-51 carbapenemase genes. Conclusion: Active surveillance and enhanced infection control measures effectively contained spread of CRAB clone in the neonatal intensive care unit. © Springer-Verlag Berlin Heidelberg 2014