Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Neonatal Intensive Care Unit

The present study describes an epidemiological investigation into a carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) outbreak, which had occurred in a neonatal intensive care unit (NICU), and the subsequent strengthening of infection control interventions. Upon the onset of the...

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Bibliographic Details
Main Authors: Jia Jie Woon, Azanna Ahmad Kamar, Cindy Shuan Ju Teh, Nuryana Idris, Rosliza Zhazali, Suzana Saaibon, Harvinderjit Kaur Basauhra Singh, Jasreena Kaur Gill Charanjeet Singh, Adeeba Kamarulzaman, Sasheela Ponnampalavanar
Format: Article
Language:English
Published: MDPI AG 2023-04-01
Series:Microorganisms
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Online Access:https://www.mdpi.com/2076-2607/11/4/1073
Description
Summary:The present study describes an epidemiological investigation into a carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) outbreak, which had occurred in a neonatal intensive care unit (NICU), and the subsequent strengthening of infection control interventions. Upon the onset of the outbreak, existing infection control interventions were reviewed, and a set of containment measures were instituted. All CRAB isolates were characterized in terms of antimicrobial susceptibility testing and their genetic relatedness. The investigation process identified gaps within the NICU’s existing infection control measures, which had likely resulted in the outbreak. CRAB was isolated from nine preterm infants: five colonized and four infected. All five colonized patients were discharged well. However, three out of four of the infected infants died. Outbreak investigation and genomic subtyping of environmental swabs revealed that mini syringe drivers shared between patients and a sink in the milk preparation room had served as CRAB reservoirs with possible transmission via the hands of healthcare workers. Implementation of immediate actions such as reinforcement of hand hygiene practices, intensified environmental cleaning, geographical cohorting, reviewing of milk handling practices and sink management protocol had resulted in no further CRAB isolation. The CRAB outbreak in the NICU underlines the importance of consistent compliance with infection-control interventions. Integration of epidemiological and microbiological data, together with comprehensive preventive measures, successfully brought the outbreak to a halt.
ISSN:2076-2607