All issues > Volume 43(1); 2000

Original Article

J Korean Pediatr Soc. 2000;43(1):43-48. Published online January 15, 2000.

Clinical and Molecular-epidemiologic Analysis of A Nosocomial Outbreak of Acinetobacter baumannii in a Neonatal Intensive Care Unit

Hye Kyung HK Lee¹, Han Jin HJ Kim², Young Chang YC Kim¹, Sung Ran SR Cho¹, Hwi Jun HJ Kim², Wee Gyo WG Lee³

¹Department of Pediatric, College of Medicine Soonchunhyang University, Chunan, Korea
²Department of Pediatric, College of Medicine Soonchunhyang University, Chunan, Korea
³Department of Clinical Pathology, College of Medicine, Ajou University, Chunan, Korea

Abstract

Purpose
: Acinetobacter species are aerobic gram-negative rods that can be widely found in nature and are a part of the normal flora of humans. The most clinical isolates of A. baumannii reflect infection rather than colonization. Recent reports suggest that the organisms cause serious and often fetal nosocomial infection such as ventilator-associated pneumonia.
Methods
: From March to September 1998, we experienced thirty clinical isolates of A. baumannii in fifteen patients in Sonchunhyang University Chunan Hospital neonatal intensive care unit. Clinical characteristics, bacteriologic investigation, and molecular epidemiologic investigation by randomly amplified polymorphic DNA(RAPD) method was performed.
Results
: The number of clinical isolates of A. baumannii were thirty and the number of Acinetobacter cases were fifteen. The duration of hospitalization and ventilator support were significantly longer in the patient group than in the control group. The most common culture site of A. baumannii was the endotracheal tube(83.3%). The thirty clinical isolates showed resistance to the most commonly used antibiotics. The RAPD result of A. baumannii isolated from fifteen patients showed the same band patterns, designating they were of the same strain. Surveillance cultures of medical staffs' hands, incubators, and ventilators failed to identify the source of infections.
Conclusion
: It is possible to have an outbreak of A. baumannii in a neonatal intensive care unit. In A. baumannii infection, the durations of hospitalization and ventilator support were significantly longer. It is very difficult to discover the source of A. baumannii outbreak.

Keywords :Acinetobacter baumannii, Outbreak of neonatal intensive care unit, RAPD