To analyze the infection outbreaks, control measures and outcomes of the outbreak in the NICU of a tertiary care centre in the year 2018.
This study was conducted in a 30 bedded tertiary care NICU from January 2018 through December 2018. The study design was an Outbreak investigation, based on a program of prospective surveillance for nosocomial infection. All neonates admitted to the NICU formed part of the the study. An Infection Control Quality Improvement (QI) team was available to analyze the infection and initiate response action to outbreaks.
Three outbreaks were reported in the year 2018. The first was in May 2018 and comprised of colonization with rectal Multi-drug resistant gram negative bacilli (MDR GNB). The outbreak was controlled by using Aseptic non-touch technique (ANTT) for fortification of milk and using distilled water for cleaning of diaper area. The second outbreak in August 2018 was Methicillin resistant Staphylococcus aureus (MRSA) whose source was a maternal Lower segment cesarean section (LSCS) wound. The third outbreak in October 2018 was MDR Acinetobacter. The source was from an outborn having the same organism. All infants were in close proximity to the index case. This outbreak was controlled with cohorting, hand hygiene and strengthening of bundle care.
Surveillance aids in early detection and successful control of outbreaks. A systematic search for the source and meticulous containment of spread can successfully control an outbreak.
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Gastmeier P, Loui A, Stamm-Balderjahn S, et al. Outbreaks in neonatal intensive care units - they are not like others. Am J Infect Control. 2007;35:172–6.
Stone PW, Gupta A, Loughrey M, et al. Attributable costs and length of stay of an extended-spectrum beta-lactamase-producing Klebsiella pneumoniae outbreak in a neonatal intensive care unit. Infect Control Hosp Epidemiol. 2003;24:601–6.
Anthony M, Bedford-Russell A, Cooper T, et al. Managing and preventing outbreaks of gram-negative infections in UK neonatal units. Arch Dis Child Fetal Neonatal Ed. 2013;98:F549–53.
Investigators of the Delhi Neonatal Infection Study (DeNIS) collaboration. Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: a cohort study. Lancet Glob Health. 2016;4:e752–60.
Vonberg R-P, Weitzel-Kage D, Behnke M, Gastmeier P. Worldwide outbreak database: the largest collection of nosocomial outbreaks. Infection. 2011;39:29–34.
Ramsing BGU, Arpi M, Andersen EA, et al. First outbreak with MRSA in a Danish neonatal intensive care unit: risk factors and control procedures. PLoS One. 2013;8:e66904.
Iosifidis E, Evdoridou I, Agakidou E, et al. Vancomycin-resistant enterococcus outbreak in a neonatal intensive care unit: epidemiology, molecular analysis and risk factors. Am J Infect Control. 2013;41:857–61.
Cassettari VC, da Silveira IR, Dropa M, et al. Risk factors for colonisation of newborn infants during an outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in an intermediate-risk neonatal unit. J Hosp Infect. 2009;71:340–7.
Lepelletier D, Corvec S, Caillon J, Reynaud A, Rozé J-C, Gras-Leguen C. Eradication of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit: which measures for which success? Am J Infect Control. 2009;37:195–200.
Al-Tawfiq JA. Father-to-infant transmission of community-acquired methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Infect Control Hosp Epidemiol. 2006;27:636–7.
An outbreak of Acinetobacter baumannii septicemia in a neonatal intensive care unit of a university hospital in Brazil. - PubMed - NCBI [Internet]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16270122?dopt=Abstract. Accessed 9 Dec 2018.
Chan P-C, Huang L-M, Lin H-C, et al. Control of an outbreak of pandrug-resistant Acinetobacter baumannii colonization and infection in a neonatal intensive care unit. Infect Control Hosp Epidemiol. 2007;28:423–9.
The authors thank all the faculty, Fellows, Post-graduates and nurses who enabled them to overcome this outbreak.
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Balachander, B., Rajesh, D., Pinhero, C.L. et al. Response Measures to Infection Outbreaks During the Second Year of Sustenance Phase of Infection Control Quality Improvement. Indian J Pediatr (2020). https://doi.org/10.1007/s12098-020-03201-6
- Infectious disease outbreak
- Multi-drug resistant Acinetobacter
- Methicillin resistant Staphylococcus aureus