Bacterial outbreaks in a Neonatal Intensive Care Unit: a five year history

Abstract

Introduction: Neonatal Intensive Care Unit (NICU) hospitalization is usually prolonged, and neonates are submitted to several risk factors, allowing the occurrence of outbreaks from time to time despite precautions. Objective: To investigate the occurrence of bacterial outbreaks in an NICU of a university hospital in the interior of Minas Gerais from January 2013 to December 2017. Methods: Data were collected from the records of outbreaks occurring in NICUs available in the documents of the Hospital Infection Control Service, including the National Healthcare Safety Network - NHSN records, memos, test results, and electronic records of outbreak descriptions. Results: Four outbreaks were observed over a fiveyear study period. The first outbreak occurred in 2013, due to infection of the bloodstream by the species Pantoea agglomerans and involved six neonates. The second occurred between November 2014 and March 2015, where six neonates were involved and there was no predominant site, Acinetobacter B being the microorganism isolated. Similarly, the third outbreak occurred in 2015 by the same agent, comprising 10 neonates. The last outbreak occurred in 2016 by Pseudomonas aeruginosa, being a predominantly colonization outbreak, where 13 neonates were affected. There were no outbreaks in 2017. Conclusion: Four epidemiological outbreaks were identified, all of them by Gram-negative bacteria. The most affected neonates were preterm and low birth-weight infants. Microorganisms resistant to carbapenems have been identified which, although few, proved to be a problem at the study site.