An outbreak of bloodstream infection due to extensively resistant Acinetobacter baumannii among neonates

Background Extensively resistant Acinetobacter baumanniihas emerged and spread worldwide as a significant cause of health care-associated infections and outbreaks. It also causes life-threatening infections among neonates, including bacteremia. The aim of this study was to investigate an outbreakof A baumannii bacteremia( ABB) among neonates. Materials and methods A retrospective, case-control studywas conducted from July 2014 to July 2015 in a neonatal intensive care unit (NICU). Risk factors associated with ABBin univariate and multivariate analysiswith logistic regression was performed. Molecular typing by pulsed field gel electrophoresiswas used to confirm relatedness of bacteremic A baumannii strains. Results During the 5-year period (2011-2016), 68 patients in our NICU were diagnosed with BSI due to A baumannii . The case-control studyincluded 41 case patients within the outbreakcaused by a major epidemic clone and 108 control patients. Risk factors (by univariate analysis) associated with ABBwere intubation, 14-day mortality, and use of peritoneal dialysis and an umbilical catheter. Multivariate analysisidentified 14-day mortality (odds ratio, 5.75; 95% confidence interval, 2.58-12.79) and umbilical catheter use (odds ratio, 2.44; 95% confidence interval, 1.1-5.4) as independent risk factors for ABB. Conclusions This outbreakof bacteremiadue to resistant A baumannii affected 41 infants and was associated with 58% mortality. Control of the outbreakwas achieved by implementing long-term sustained infection control measures within the unit.