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Response Measures to Infection Outbreaks During the Second Year of Sustenance Phase of Infection Control Quality Improvement

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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.

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The authors thank all the faculty, Fellows, Post-graduates and nurses who enabled them to overcome this outbreak.

Author information

BB: Conceptualised the idea and wrote the first draft manuscript; DR: Aided in literature search, edited the first draft manuscript and performed data collection; CLP, SP and SS: Nurses who were involved in data collection and contributed to source identification and control of outbreaks; SR: Reviewed the manuscript and finalised the manuscript. SR will act as guarantor for this paper.

Correspondence to Suman Rao.

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Balachander, B., Rajesh, D., Pinhero, C.L. et al. Response Measures to Infection Outbreaks During the Second Year of Sustenance Phase of Infection Control Quality Improvement. Indian J Pediatr (2020). https://doi.org/10.1007/s12098-020-03201-6

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  • Infectious disease outbreak
  • Surveillance
  • Multi-drug resistant Acinetobacter
  • Methicillin resistant Staphylococcus aureus