[Acinetobacter in a metropolitan neonatal unit: clinical and microbiological aspects]

Acinetobacter calcoaceticus var. anitratus (ACA) was isolated from two newborn infants and var. Iwoffi of the same species from a third patient within a month in the neonatal unit of a general hospital at Metropolitan Santiago, Chile. The first isolate was obtained from a neonate with infection of the skin surrounding a colostomy operation after surgery for tracheo esophageal fistulae, in march 1989. The second case's skin became colonized after he was admitted for surgical repair of severe gastroesophageal reflux into the same ward room and nursed in proximity to the first case, making necessary the use of antibiotic prophylaxis with sulbactam-ampicillin prior to surgery. The third case, a very immature female baby, was born at the same month; she had early septicaemia due to Acinetobacter calcoaceticus var. Iwoffi sensitive to gentamicin and after appropriate treatment her clinical recovery was uneventful. In the microbiological study of the neonatal unit this last microorganism was isolated from thermometers of the nursery and on the hands of one member of the nursing staff, while ACA had been reported at the preceding month from operating rooms and anesthesia equipment. Intensive surveillance of ward's environment, equipment and personnel, barrier precautions, and improved staff handwashing were then instituted and extension of an outbreak was thus avoided.