Acinetobacter calcoaceticus biovar anitratus septicaemia in a neonatal intensive care unit: epidemiology and control.

Nineteen neonates with septicaemia caused by Acinetobacter calcoaceticus biovar anitratus were treated in a neonatal intensive care unit between October, 1983 and March, 1986. The ages of the patients at the onset of septicaemia ranged from 4 to 22 days (mean 9.7 days). Their birth weights ranged from 1000 g to 3350 g (mean 1790 g) and were less than 2000 g in 14 patients. Antibiotics had been administered to 17 of the 19 neonates before the onset of septicaemia, and all mature infants had received prior antibiotic therapy, intubation or had suffered from a convulsion. Acinetobacter anitratus strains were isolated from pharyngeal swabs and/or faeces from 35 (79.5%) out of 44 infants of less than 2000 g. These strains were also isolated from the hands of staff members, and from equipment such as sinks and baths in the unit. It was likely that nosocomial infection via the hands of the staff occurred. Encouraging frequent hand-washing, strict antibiotic use, and cohorting of colonized infants resulted in a reduction of colonization and no further cases of septicaemia were reported.