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 i nfected/colonized with Enterobacter cloacae was seen in the neonatal i ntensive care unit of the University Hospital Nijmegen. The results of the epidemiological investigation are reported, which was aimed to di fferentiate between a random cluster of endogenously acquired Enteroba cter strains and those possibly acquired exogenously via cross-infecti on. 5 isolates of the 7 patients were available for fingerprinting usi ng interrepeat PCR. According to the fingerprint pattern, 4 of these i solates were identical, thereby suggesting cross-infection among the c hildren. 3 neonates were colonized/infected with genotypically differe nt isolates, suggesting that the infection/colonization developed endo genously. A control strain isolated from a patient at another ward sho wed the same genotype as the outbreak isolates. The transmission took probably place through one of the surgeons who, among all possible hea lth care workers, were the only professional group treating patients i n both units.