Outbreak of Acinetobacter baumannii bacteremia in a neonatal intensive care unit: Clinical implications and genotyping analysis

Yhu Chering Huang, Lin Hui Su, Tsu Lan Wu, Hsieh Shong Leu, Wu Shiun Hsieh, Tung Mei Chang, Tzou Yien Lin

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background. Outbreaks of sepsis associated with Acinetobacter baumannii have been rarely reported in neonatal intensive care units (NICUs). We describe such an outbreak in a NICU, and the results of molecular epidemiologic investigations are presented. Materials and methods. Between August and September 2000, 6 premature infants hospitalized in a pediatric NICU developed A. baumannii sepsis. Three additional cases had Acinetobacter infections during November and December. For an environmental culture survey, 94 environmental specimens and hand washings of all 43 health care workers involved in this unit were examined for the presence of this organism. Two genotyping methods, pulsed field gel electrophoresis of genomic DNA digested with SmaI and infrequent restriction site polymerase chain reaction, were used to analyze the 9 bacteremic isolates and any A. baumannii isolates obtained from the environmental survey and the hand washings. Another 3 bacteremic isolates of A. baumannii collected in the same NICU in 1999 were incorporated as controls. Results. The 9 infants were premature and had birth weights of <1500 g. Before onset of sepsis 9 infants had received total parenteral nutrition, and 8 infants had had central venous catheters and received intrafat emulsion. Five (5.3%) environmental specimens and 10 (23.3%) hand washing specimens were positive for the organism. Except for the strain from Case 9, the results of both genotyping methods were concordant; 11 patterns were identified by infrequent restriction site polymerase chain reaction and 10 patterns by pulsed field gel electrophoresis. One major genotype was demonstrated in the first 6 bacteremic isolates as well as 3 hand washing isolates. The genotypes of the other 3 bacteremic isolates, the 3 control strains, the 5 environmental isolates and 7 other hand washing isolates were distinct from the genotype of outbreak strains. Conclusion. An outbreak of A. baumannii bacteremia in a NICU was clearly demonstrated by the molecular epidemiologic investigation and was possibly transmitted via the hands of health care workers.

Original languageEnglish
Pages (from-to)1105-1109
Number of pages5
JournalPediatric Infectious Disease Journal
Volume21
Issue number12
DOIs
Publication statusPublished - Dec 1 2002
Externally publishedYes

Fingerprint

Acinetobacter baumannii
Hand Disinfection
Neonatal Intensive Care Units
Bacteremia
Disease Outbreaks
Sepsis
Pulsed Field Gel Electrophoresis
Genotype
Acinetobacter Infections
Delivery of Health Care
Polymerase Chain Reaction
Pediatric Intensive Care Units
Central Venous Catheters
Total Parenteral Nutrition
Premature Birth
Emulsions
Birth Weight
Premature Infants
Hand
DNA

Keywords

  • Acinetobacter baumannii
  • Bacteremia
  • Genotyping
  • Neonatal intensive care unit
  • Outbreak

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Outbreak of Acinetobacter baumannii bacteremia in a neonatal intensive care unit : Clinical implications and genotyping analysis. / Huang, Yhu Chering; Su, Lin Hui; Wu, Tsu Lan; Leu, Hsieh Shong; Hsieh, Wu Shiun; Chang, Tung Mei; Lin, Tzou Yien.

In: Pediatric Infectious Disease Journal, Vol. 21, No. 12, 01.12.2002, p. 1105-1109.

Research output: Contribution to journalArticle

Huang, Yhu Chering ; Su, Lin Hui ; Wu, Tsu Lan ; Leu, Hsieh Shong ; Hsieh, Wu Shiun ; Chang, Tung Mei ; Lin, Tzou Yien. / Outbreak of Acinetobacter baumannii bacteremia in a neonatal intensive care unit : Clinical implications and genotyping analysis. In: Pediatric Infectious Disease Journal. 2002 ; Vol. 21, No. 12. pp. 1105-1109.
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abstract = "Background. Outbreaks of sepsis associated with Acinetobacter baumannii have been rarely reported in neonatal intensive care units (NICUs). We describe such an outbreak in a NICU, and the results of molecular epidemiologic investigations are presented. Materials and methods. Between August and September 2000, 6 premature infants hospitalized in a pediatric NICU developed A. baumannii sepsis. Three additional cases had Acinetobacter infections during November and December. For an environmental culture survey, 94 environmental specimens and hand washings of all 43 health care workers involved in this unit were examined for the presence of this organism. Two genotyping methods, pulsed field gel electrophoresis of genomic DNA digested with SmaI and infrequent restriction site polymerase chain reaction, were used to analyze the 9 bacteremic isolates and any A. baumannii isolates obtained from the environmental survey and the hand washings. Another 3 bacteremic isolates of A. baumannii collected in the same NICU in 1999 were incorporated as controls. Results. The 9 infants were premature and had birth weights of <1500 g. Before onset of sepsis 9 infants had received total parenteral nutrition, and 8 infants had had central venous catheters and received intrafat emulsion. Five (5.3{\%}) environmental specimens and 10 (23.3{\%}) hand washing specimens were positive for the organism. Except for the strain from Case 9, the results of both genotyping methods were concordant; 11 patterns were identified by infrequent restriction site polymerase chain reaction and 10 patterns by pulsed field gel electrophoresis. One major genotype was demonstrated in the first 6 bacteremic isolates as well as 3 hand washing isolates. The genotypes of the other 3 bacteremic isolates, the 3 control strains, the 5 environmental isolates and 7 other hand washing isolates were distinct from the genotype of outbreak strains. Conclusion. An outbreak of A. baumannii bacteremia in a NICU was clearly demonstrated by the molecular epidemiologic investigation and was possibly transmitted via the hands of health care workers.",
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AU - Leu, Hsieh Shong

AU - Hsieh, Wu Shiun

AU - Chang, Tung Mei

AU - Lin, Tzou Yien

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N2 - Background. Outbreaks of sepsis associated with Acinetobacter baumannii have been rarely reported in neonatal intensive care units (NICUs). We describe such an outbreak in a NICU, and the results of molecular epidemiologic investigations are presented. Materials and methods. Between August and September 2000, 6 premature infants hospitalized in a pediatric NICU developed A. baumannii sepsis. Three additional cases had Acinetobacter infections during November and December. For an environmental culture survey, 94 environmental specimens and hand washings of all 43 health care workers involved in this unit were examined for the presence of this organism. Two genotyping methods, pulsed field gel electrophoresis of genomic DNA digested with SmaI and infrequent restriction site polymerase chain reaction, were used to analyze the 9 bacteremic isolates and any A. baumannii isolates obtained from the environmental survey and the hand washings. Another 3 bacteremic isolates of A. baumannii collected in the same NICU in 1999 were incorporated as controls. Results. The 9 infants were premature and had birth weights of <1500 g. Before onset of sepsis 9 infants had received total parenteral nutrition, and 8 infants had had central venous catheters and received intrafat emulsion. Five (5.3%) environmental specimens and 10 (23.3%) hand washing specimens were positive for the organism. Except for the strain from Case 9, the results of both genotyping methods were concordant; 11 patterns were identified by infrequent restriction site polymerase chain reaction and 10 patterns by pulsed field gel electrophoresis. One major genotype was demonstrated in the first 6 bacteremic isolates as well as 3 hand washing isolates. The genotypes of the other 3 bacteremic isolates, the 3 control strains, the 5 environmental isolates and 7 other hand washing isolates were distinct from the genotype of outbreak strains. Conclusion. An outbreak of A. baumannii bacteremia in a NICU was clearly demonstrated by the molecular epidemiologic investigation and was possibly transmitted via the hands of health care workers.

AB - Background. Outbreaks of sepsis associated with Acinetobacter baumannii have been rarely reported in neonatal intensive care units (NICUs). We describe such an outbreak in a NICU, and the results of molecular epidemiologic investigations are presented. Materials and methods. Between August and September 2000, 6 premature infants hospitalized in a pediatric NICU developed A. baumannii sepsis. Three additional cases had Acinetobacter infections during November and December. For an environmental culture survey, 94 environmental specimens and hand washings of all 43 health care workers involved in this unit were examined for the presence of this organism. Two genotyping methods, pulsed field gel electrophoresis of genomic DNA digested with SmaI and infrequent restriction site polymerase chain reaction, were used to analyze the 9 bacteremic isolates and any A. baumannii isolates obtained from the environmental survey and the hand washings. Another 3 bacteremic isolates of A. baumannii collected in the same NICU in 1999 were incorporated as controls. Results. The 9 infants were premature and had birth weights of <1500 g. Before onset of sepsis 9 infants had received total parenteral nutrition, and 8 infants had had central venous catheters and received intrafat emulsion. Five (5.3%) environmental specimens and 10 (23.3%) hand washing specimens were positive for the organism. Except for the strain from Case 9, the results of both genotyping methods were concordant; 11 patterns were identified by infrequent restriction site polymerase chain reaction and 10 patterns by pulsed field gel electrophoresis. One major genotype was demonstrated in the first 6 bacteremic isolates as well as 3 hand washing isolates. The genotypes of the other 3 bacteremic isolates, the 3 control strains, the 5 environmental isolates and 7 other hand washing isolates were distinct from the genotype of outbreak strains. Conclusion. An outbreak of A. baumannii bacteremia in a NICU was clearly demonstrated by the molecular epidemiologic investigation and was possibly transmitted via the hands of health care workers.

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