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An Outbreak of Carbapenem-Resistant Acinetobacter baumannii Infection in a Neonatal Intensive Care Unit: Investigation and Control

Published online by Cambridge University Press:  02 January 2015

Eric J. McGrath ,
Teena Chopra ,
Nahed Abdel-Haq ,
Katherine Preney ,
Winston Koo ,
Basim I. Asmar  and
Keith S. Kaye
Eric J. McGrath*
Affiliation:
Wayne State University School of Medicine, Carman and Ann Adams Department of Pediatrics, Division of Infectious Diseases, Detroit, Michigan
Teena Chopra
Affiliation:
Department of Internal Medicine, Division of Infectious Diseases, Detroit, Michigan
Nahed Abdel-Haq
Affiliation:
Wayne State University School of Medicine, Carman and Ann Adams Department of Pediatrics, Division of Infectious Diseases, Detroit, Michigan
Katherine Preney
Affiliation:
Hutzel Women's Hospital, Detroit, Michigan Detroit Medical Center, Detroit, Michigan
Winston Koo
Affiliation:
Division of Neonatology, Detroit, Michigan Hutzel Women's Hospital, Detroit, Michigan
Basim I. Asmar
Affiliation:
Wayne State University School of Medicine, Carman and Ann Adams Department of Pediatrics, Division of Infectious Diseases, Detroit, Michigan
Keith S. Kaye
Affiliation:
Department of Internal Medicine, Division of Infectious Diseases, Detroit, Michigan Detroit Medical Center, Detroit, Michigan
*
MD, Division of Infectious Diseases, Children's Hospital of Michigan, 3901 Beaubien Street, Detroit, MI 48201 (emcgrath@med.wayne.edu)
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Abstract

Objective.

To investigate the mode of transmission of and assess control measures for an outbreak of carbapenem-resistant (multidrug-resistant) Acinetobacter baumannii infection involving 6 premature infants.

Design.

An outbreak investigation based on medical record review was performed for each neonate during the outbreak (from November 2008 through January 2009) in conjunction with an infection control investigation.

Setting.

A 36-bed, level 3 neonatal intensive care unit in a university-affiliated teaching hospital in Detroit, Michigan.

Interventions.

Specimens were obtained for surveillance cultures from all infants in the unit. In addition, geographic cohorting of affected infants and their nursing staff, contact isolation, re-emphasis of adherence to infection control practices, environmental cleaning, and use of educational modules were implemented to control the outbreak.

Results.

Six infants (age, 10-197 days) with multidrug-resistant A. baumannii infection were identified. All 6 infants were premature (gestational age, 23-30 weeks) and had extremely low birth weights (birth weight, 1000 g or less). Conditions included conjunctivitis (2 infants), pneumonia (4 infants), and bacteremia (1 infant). One infant died of causes not attributed to infection with the organism; the remaining 5 infants were discharged home. All surveillance cultures of unaffected infants yielded negative results.

Conclusions.

The spread of multidrug-resistant A. baumannii infection was suspected to be due to staff members who spread the pathogen through close contact with infants. Clinical staff recognition of the importance of multidrug-resistant A. baumannii recovery from neonatal intensive care unit patients, geographic cohorting of infected patients, enhanced infection control practices, and staff education resulted in control of the spread of the organism.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 32 , Issue 1 , January 2011 , pp. 34 - 41
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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