USAGE OF PCR FINGERPRINTING TO CONFIRM AN ENTEROBACTER-CLOACAE OUTBREAK IN A NEONATAL INTENSIVE-CARE UNIT

Between end December 1993 and end January 1994 a cluster of children infected/colonized with Enterobacter cloacae was seen in the neonatal intensive care unit of the University Hospital Nijmegen. The results of the epidemiological investigation are reported, which was aimed to differentiate between a random cluster of endogenously acquired Enterobacter strains and those possibly acquired exogenously via cross-infection. 5 isolates of the 7 patients were available for fingerprinting using interrepeat PCR. According to the fingerprint pattern, 4 of these isolates were identical, thereby suggesting cross-infection among the children. 3 neonates were colonized/infected with genotypically different isolates, suggesting that the infection/colonization developed endogenously. A control strain isolated from a patient at another ward showed the same genotype as the outbreak isolates. The transmission took probably place through one of the surgeons who, among all possible health care workers, were the only professional group treating patients in both units.