Department of Neonatology, St. John's Medical College Hospital, Bangalore, Karnataka, India.
Indian J Pediatr. 2020 May;87(5):333-338. doi: 10.1007/s12098-020-03201-6. Epub 2020 Feb 8.
To analyze the infection outbreaks, control measures and outcomes of the outbreak in the NICU of a tertiary care centre in the year 2018.
This study was conducted in a 30 bedded tertiary care NICU from January 2018 through December 2018. The study design was an Outbreak investigation, based on a program of prospective surveillance for nosocomial infection. All neonates admitted to the NICU formed part of the the study. An Infection Control Quality Improvement (QI) team was available to analyze the infection and initiate response action to outbreaks.
Three outbreaks were reported in the year 2018. The first was in May 2018 and comprised of colonization with rectal Multi-drug resistant gram negative bacilli (MDR GNB). The outbreak was controlled by using Aseptic non-touch technique (ANTT) for fortification of milk and using distilled water for cleaning of diaper area. The second outbreak in August 2018 was Methicillin resistant Staphylococcus aureus (MRSA) whose source was a maternal Lower segment cesarean section (LSCS) wound. The third outbreak in October 2018 was MDR Acinetobacter. The source was from an outborn having the same organism. All infants were in close proximity to the index case. This outbreak was controlled with cohorting, hand hygiene and strengthening of bundle care.
Surveillance aids in early detection and successful control of outbreaks. A systematic search for the source and meticulous containment of spread can successfully control an outbreak.
分析 2018 年一家三级护理中心新生儿重症监护病房（NICU）的感染爆发、控制措施和结果。
本研究于 2018 年 1 月至 12 月在一家拥有 30 张床位的三级护理 NICU 进行。研究设计为爆发调查，基于医院获得性感染的前瞻性监测计划。所有入住 NICU 的新生儿均为研究对象。感染控制质量改进（QI）团队随时分析感染情况并采取应对措施。
2018 年报告了 3 次爆发。第一次爆发于 2018 年 5 月，涉及直肠多重耐药革兰阴性菌（MDR GNB）定植。通过使用无菌非接触技术（ANTT）强化牛奶和使用蒸馏水清洁尿布区域来控制爆发。第二次爆发于 2018 年 8 月，是耐甲氧西林金黄色葡萄球菌（MRSA），其来源是一位产妇的下腹部剖宫产（LSCS）伤口。第三次爆发于 2018 年 10 月，是 MDR 不动杆菌。来源是一名外来患儿，携带相同的病原体。所有婴儿都与索引病例密切接触。通过分组、手部卫生和强化捆绑护理来控制这次爆发。
监测有助于早期发现和成功控制爆发。系统搜索源头并细致控制传播可以成功控制爆发。
