1778. Outbreak of Multidrug-resistant Acinetobacter baumanni i  in Neonatal Intensive Care Unit in El Salvador
Session: Poster Abstract Session: Resistant Gram-Negative Infections: Acinetobacter
Saturday, October 10, 2015
Room: Poster Hall
Outbreak of Multidrug-resistant Acinetobacter baumanni i  in Neonatal Intensive Care Unit in El Salvador

Background:

Multidrug-resistant Acinetobacter baumannii is recognized to be among the most difficult antimicrobial-resistant gram-negative bacilli to control and treat. the first case was reported in our hospital in October 2014.

epidemiology, risk factors and treatment.

In addition to assessing whether control measures were effective. the contribution of cross-transmission in the rise in infection rates

Methods:

Epidemiological investigation and  matched case-control study to identify risk factors for infection.

18 neonatal intensive care beds and 30 neonatal beds.

16 patients who developed MDRA baumannii nosocomial infection were matched to 32 patients who were admitted to the same intensive care unit (SICU) room and neonates  did not develop an infection during the outbreak period.

Results:

Before the outbreak, the attack rate baseline of MDR A. baumannii nosocomial infection was 1 per 100 patients per month. From January 14, 2014 to April 15, 2015, the attack rate was raised to 8 per 100 patients per month, with a total of 16 infections. 37 environmental cultures were negative for MDR A. baumannii. After an intense education and implementing infection control measures, the attack rate was reduced to 1-2 per 100 patients per month. By logistic regression risk factors associated with disease development were days long stay, use of carbapenems, abdominal surgery and after colonization with A. baumanni  (Odds ratio, 1.1; confidence interval 95%, 01/01 to 01/02, p = 0.02). Mortality rate  32%, sepsis lethality  52%, all patients were treated with fosfomycin, meropenem and ampicillin / sulbactam combination therapy

Conclusion:

Cross-transmission between patients contributed to the rise in rates of MDR A. baumannii infections. A common environmental source was not detected. Given the lack of good treatment options should be given greater emphasis on prevention measures to control outbreaks

Miriam Duenas, Pediatric infectious disease, Chief of Department of Infectious Diseases, Hospital Nacional de Niņos Bnejamin Bloom, San Salvador, El Salvador

Disclosures:

M. Duenas, None

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