Abstract
Objective: We investigated a long outbreak of a nosocomial infection of Acinetobacter baumannii (A. baumannii) in the neonatal intensive care unit (NICU) of Vali-Asr teaching hospital in Tehran, Iran. Methods: Within a 19-month period, 25 neonates infected with A. baumannii were discovered. We divided the outbreak period into two groups according to the time they were infected. Group 1 was comprised of cases infected with A. baumannii from February to May 2016 (12 cases), and group 2 was neonates infected from November 2014 to January 2016 (13 cases). Identification of A. baumannii was executed by the phenotypic standards. Logistic regression analysis and multiple correspondence analyses (MCA) were used for comparison of groups with various variables. Results: This outbreak had a common source with intermittent exposure, it ascended gradually and plateaued. Overall, 68.0% of the neonates had a birth weight of 2,499 grams or less, and 84% were born preterm. Of the 25 infants, bloodstream involvement was present in 8 (66.7%) and 10 (76.9%) (P-value=0.450), and infection in trachea occurred in 7 (53.8%) and 3 (25.0%) (P-value=0.144) in group 1 and 2 respectively. In multiple logistic regression analysis, the number of prescribed antibiotics had a significant positive effect on increasing the slope in the epidemic curve (group 1). The first and second dimensions presented in MCA were 54.25% and 20.45% respectively. Three categories concluded prescription of amphotericin, fluconazole, and being in group 1 was placed in very close coordination both in dimension 1 and 2. Conclusion: It seems that the antifungals and number of prescribed antibiotics played an important role in intensifying the outbreak of A. baumannii infection.
Highlights
MethodsWithin 19 months period, 25 neonates infected with A. baumannii were discovered
It seems that the antifungals and number of prescribed antibiotics played an important role in intensifying the outbreak of A. baumannii infection
Numerous nosocomial outbreaks caused by Acinetobacter have been reported globally [7,8,9,10,11]
Summary
Within 19 months period, 25 neonates infected with A. baumannii were discovered. We divided the outbreak period into two groups according to the time they were infected. The NICU of Vali-Asr, a Teaching Hospital affiliated with the Tehran University of Medical Sciences, has 39 beds and appropriate equipment for neonates requiring intensive care such as, mechanical ventilation, cardiac cares, and other. From November 2014 until May 2016 (19 months), 889 neonates were admitted to the NICU for various causes. The variables included, birth weight, gestational age, gender, weight in inpatient day, duration of hospitalization, Apgar score at one and five minutes, output of admission (dead or discharged), mothers’ and babies’ underlying disease, cause of inpatient, incubator care, use of antibiotics, name of antibiotics, use of mechanical ventilation, central or peripheral venous catheter, Granulocyte-Colony Stimulating Factor (G-CSF), chest tube, and surfactant
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