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Enterobacter aerogenes outbreak in a neonatal intensive care unit
1Department of Pediatrics, University College of Medical Sciences, Shahdara, Delhi, India.
Summary
Enterobacter aerogenes caused a deadly outbreak of septicemia in a NICU, affecting 13 newborns. Rapid antibiotic resistance and high mortality highlight the virulence of this nosocomial pathogen.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Bacteriology
Background:
- Enterobacter aerogenes is an infrequent cause of nosocomial bacteremia in neonates.
- An outbreak occurred in a NICU, with 13 cases identified within 70 days.
Purpose of the Study:
- To summarize the clinical and bacteriological aspects of E. aerogenes septicemia in neonates.
- To investigate the source of infection and control the outbreak.
- To analyze the outcomes and antibiotic sensitivity of affected infants.
Main Methods:
- Retrospective analysis of 13 neonates with E. aerogenes septicemia.
- Clinical data, including birthweight, gestational age, and complications, were reviewed.
- Bacteriological data, including antibiotic sensitivity, were analyzed.
- Source tracing and outbreak control measures were implemented.
Main Results:
- All 13 neonates had perinatal risk factors; mean birthweight was 1880g.
- Clinical presentation was similar to other Gram-negative septicemia, with complications including sclerema, bleeding, meningitis, and shock.
- Antibiotic sensitivity varied, with initial resistance followed by sensitivity to certain antibiotics, and resistance in the final case.
- Mortality rate was 46.2%, with a short interval between symptom onset and death.
- The outbreak was traced to a suction machine's rubber pipe.
Conclusions:
- Enterobacter aerogenes can cause severe nosocomial outbreaks in NICUs.
- Low birthweight infants with perinatal risks are susceptible.
- The organism exhibits rapid acquisition/loss of antibiotic resistance.
- The strain demonstrated high virulence, leading to significant mortality.