title: Successful management of an outbreak due to carbapenem-resistant Acinetobacter baumannii in a neonatal intensive care unit.
abstract: The investigation and successful management of a monoclonal Acinetobacter baumannii outbreak in a neonatal intensive care unit are described. Upon the first clustered carbapenem-resistant A. baumannii (CRAB) infections, a bundle of actions were taken, including enhanced infection control, active surveillance (weekly stool samples), case-control study, staff education, daily audits and discontinuation of new admissions. Between September and December 2011, eight neonates developed 10 CRAB infections (five blood, four respiratory and one eye). A total of 216 active surveillance cultures were obtained from 96 neonates (43 % had ≥2 samples). During weeks 12, 16 and 17, active surveillance detected 3, 1 and 2 new CRAB acquisitions, respectively. Prevalence of infections/colonizations decreased, and no event occurred after 20th week. A colonized neonate developed CRAB sepsis and died. All CRAB isolates harboured bla OXA-58 and the intrinsic chromosomal bla OXA-51 carbapenemase genes.
  
  
  CONCLUSIONS
  Active surveillance and enhanced infection control measures effectively contained spread of CRAB clone in the neonatal intensive care unit.
authors.affiliation: Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University School of Medicine, Hippokration General Hospital, Konstantinoupoleos 49, 546 42, Thessaloniki, Greece, olgatsi@otenet.gr.
authors.forename: Olga
authors.initials: O
authors.lastname: Tsiatsiou
authors.forename: Εlias
authors.initials: Ε
authors.lastname: Iosifidis
authors.forename: Aspasia
authors.initials: A
authors.lastname: Katragkou
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Dimou
authors.forename: Kosmas
authors.initials: K
authors.lastname: Sarafidis
authors.forename: Theodoros
authors.initials: T
authors.lastname: Karampatakis
authors.forename: Charalampos
authors.initials: C
authors.lastname: Antachopoulos
authors.forename: Anagnostina
authors.initials: A
authors.lastname: Orfanou
authors.forename: Athanasios
authors.initials: A
authors.lastname: Tsakris
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Drossou-Agakidou
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Roilides
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015780:Carbapenems / Q000009:adverse effects; D003091:Colistin / Q000627:therapeutic use; D004196:Disease Outbreaks; D005243:Feces / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D000077731:Meropenem; D011446:Prospective Studies; D013845:Thienamycins / Q000627:therapeutic use; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D013845:Thienamycins; D001618:beta-Lactamases; C577373:beta-lactamase OXA-51, Acinetobacter baumannii; C534889:beta-lactamase OXA-58, Acinetobacter baumannii; D000077731:Meropenem; D003091:Colistin