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...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
|
| Series: | Microorganisms |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-2607/11/4/1073 |
| _version_ | 1797604192482754560 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Jia Jie Woon |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T04:42:49Z |
| format | Article |
| id | doaj.art-bae49ef9451f4f1ba92d634690edb5d4 |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-11T04:42:49Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-bae49ef9451f4f1ba92d634690edb5d42023-11-17T20:34:36ZengMDPI AGMicroorganisms2076-26072023-04-01114107310.3390/microorganisms11041073Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Neonatal Intensive Care UnitJia Jie Woon0Azanna Ahmad Kamar1Cindy Shuan Ju Teh2Nuryana Idris3Rosliza Zhazali4Suzana Saaibon5Harvinderjit Kaur Basauhra Singh6Jasreena Kaur Gill Charanjeet Singh7Adeeba Kamarulzaman8Sasheela Ponnampalavanar9Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Paediatrics, Faculty of Medicine, University of Malaya, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Infection Control, University of Malaya Medical Centre, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Infection Control, University of Malaya Medical Centre, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Nursing, University of Malaya Medical Centre, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Pharmacy, University of Malaya Medical Centre, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Medicine, Faculty of Medicine, University of Malaya, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaDepartment of Medicine, Faculty of Medicine, University of Malaya, Wilayah Persekutuan Kuala Lumpur 50603, MalaysiaThe 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.https://www.mdpi.com/2076-2607/11/4/1073molecular epidemiologycarbapenem-resistant <i>Acinetobacter baumannii</i>outbreakneonatal intensive care unit |
| spellingShingle | 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 Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Neonatal Intensive Care Unit Microorganisms molecular epidemiology carbapenem-resistant <i>Acinetobacter baumannii</i> outbreak neonatal intensive care unit |
| title | Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Neonatal Intensive Care Unit |
| title_full | Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Neonatal Intensive Care Unit |
| title_fullStr | Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Neonatal Intensive Care Unit |
| title_full_unstemmed | Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Neonatal Intensive Care Unit |
| title_short | Molecular Epidemiological Investigation and Management of Outbreak Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Neonatal Intensive Care Unit |
| title_sort | molecular epidemiological investigation and management of outbreak caused by carbapenem resistant i acinetobacter baumannii i in a neonatal intensive care unit |
| topic | molecular epidemiology carbapenem-resistant <i>Acinetobacter baumannii</i> outbreak neonatal intensive care unit |
| url | https://www.mdpi.com/2076-2607/11/4/1073 |
| work_keys_str_mv | AT jiajiewoon molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT azannaahmadkamar molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT cindyshuanjuteh molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT nuryanaidris molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT roslizazhazali molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT suzanasaaibon molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT harvinderjitkaurbasauhrasingh molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT jasreenakaurgillcharanjeetsingh molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT adeebakamarulzaman molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit AT sasheelaponnampalavanar molecularepidemiologicalinvestigationandmanagementofoutbreakcausedbycarbapenemresistantiacinetobacterbaumanniiiinaneonatalintensivecareunit |