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

Journal of the Korean Pediatric Society 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 Lee1, Han Jin Kim2, Young Chang Kim1, Sung Ran Cho1, Hwi Jun Kim2, Wee Gyo 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
신생아중환자실에 집단 발생된 Acinetobacter baumannii감염의 임상 및 분자역학적 분석
이혜경1, 김한진2, 김영창1, 조성란1, 김휘준2, 이위교3
1순천향대학교 의과대학 소아과학교실
2순천향대학교 의과대학 임상병리학교실
3아주대학교 의과대학 임상병리학교실
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.
Key Words: Acinetobacter baumannii, Outbreak of neonatal intensive care unit, RAPD


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