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On 16 August 2022, the Centre for Healthcare Infections, Antimicrobial Resistance and Mycoses
(CHARM) at the NICD was informed of an increase in cases of MDR-AB infections in a neonatal ICU of a unnamed regional hospital in the KwaZulu-Natal Province, South Africa.

The cluster involved five newborn babies with multidrug-resistant Acinetobacter baumannii (MDR-AB) cultured from cerebrospinal fluid (n=3), blood (n=1) and endotracheal aspirate (n=1).
All babies had underlying conditions and four of the five cases died.
At the time of the notification, an outbreak investigation was supported by KwaZulu-Natal Provincial Department of Health, including Infection Prevention and Control (IPC), Provincial and District hospital outbreak teams, NHLS and NICD.
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In the investigation, one dominant strain with four clonal isolates were found, indicating a possible common source and/or person-to-person transmission. The unit exceeded approved bed occupancy
and was not adherent to staffing norms. Control measures included reducing bed occupancy in the unit, strengthening of IPC, such as hand hygiene and environmental cleaning, decontamination of equipment, aseptic technique for procedures, retraining of staff and surveillance. As of 26 August 2022, no further cases of MDR-AB infection were reported.
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