title: Managing and preventing outbreaks of Gram-negative infections in UK neonatal units.
abstract: De novo guidance on the management of Gram-negative bacteria outbreaks in UK neonatal units was developed in 2012 by a Department of Health, England Antimicrobial Resistance and Healthcare Associated Infection working group. The recommendations included activation of an organisational response and establishing a control team when an outbreak is suspected; screening for the specific organism only during an outbreak; undertaking multidisciplinary reviews of cleaning routines, hand hygiene and Gram-negative bacteria transmission risks; considering deep-cleaning; cohorting colonised and infected babies preferably but not necessarily in isolation cubicles; and considering reducing beds or closing a unit to new admissions as a way of improving spacing and staff:patient ratios until the outbreak is under control. The group advised establishing mechanisms to communicate effectively across the network; informing parents of the outbreak as early as possible, and providing prewritten 'infection outbreak' information sheets. For prevention of outbreaks, the group advised meeting national staffing and cot-spacing requirements; following a Water Action Plan; using infection reduction care bundles and benchmarking; and introducing breast milk early and limiting antibiotic use.
authors.affiliation: Oxford University Hospitals NHS Trust, , Headington, Oxford, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Anthony
authors.forename: Alison
authors.initials: A
authors.lastname: Bedford-Russell
authors.forename: Tracey
authors.initials: T
authors.lastname: Cooper
authors.forename: Carole
authors.initials: C
authors.lastname: Fry
authors.forename: Paul T
authors.initials: PT
authors.lastname: Heath
authors.forename: Nigel
authors.initials: N
authors.lastname: Kennea
authors.forename: Maureen
authors.initials: M
authors.lastname: McCartney
authors.forename: Bharat
authors.initials: B
authors.lastname: Patel
authors.forename: Tina
authors.initials: T
authors.lastname: Pollard
authors.forename: Mike
authors.initials: M
authors.lastname: Sharland
authors.forename: Peter
authors.initials: P
authors.lastname: Wilson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003142:Communication; D003428:Cross Infection / Q000188:drug therapy / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods*; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D010290:Parents / Q000523:psychology; D017410:Practice Guidelines as Topic
chemical_list: D000900:Anti-Bacterial Agents
keywords: Infectious Diseases; Neonatology