Acinetobacter baumannii (A. baumannii) is Gram-negative coccobacilli that has emerged as a nosocomial pathogen. Several reports in Indonesia showed the continuous presence of A. baumannii. This study aimed to determine the incidence of A. baumannii bacteremia in neonates in the Neonatal Unit Dr. Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia, and assess its role in blood stream infection using antibiogram and genotyping by pulsed-field gel electrophoresis (PFGE). Subjects were neonates with clinical sepsis. Blood specimens from the neonates and samples of suspected environment within the Neonatal Unit were cultivated. Antimicrobial resistance profiles were classified for analysis purpose. A. baumannii isolates were genotyped by PFGE to determine their similarity. A total of 24 A. baumannii were isolated from 80 neonates and the environment during this period of study. Seven isolates from the neonates showed multiple antimicrobial resistance (MDR), and 82% ( ) of the environment isolates were also MDR. Antibiotype “d” seemed to be predominant (62.5%). PFGE analysis showed a very close genetic relationship between the patients and environment isolates (Dice coefficient 0.8–1.0). We concluded that a mode of transmission of environmental microbes to patients was present in the Neonatal Unit of RSCM and thus needed to be overcome. 1. Introduction Acinetobacter spp. are ubiquitous in the environment, that is, soil and water, and occasionally isolated from mucous membrane, secretion, and skin of hospitalized patients, also on surfaces of hospital environment [1]. This aerobic Gram-negative coccobacilli has emerged as important nosocomial pathogen. Clinical sepsis (CSEP) is included in the blood stream infections (BSI) category and restricted only for infant less than 1 year old [2]. However, in protocols of CDC/NHSN 2013, CSEP criteria are not in the list of BSI group but laboratory-confirmed BSI type 1, 2, and 3 [3]. Multidrug resistance of A. baumannii has caused morbidity, mortality, and increased patients’ length of stay in hospital in many countries [4–6]. Mortality of patient with Acinetobacter sp. infection reached 17%–46% [4, 5]. The continuous presence of this environment microorganism from clinical specimens in Jakarta, Indonesia, has been reported [7, 8]. Since Acinetobacter sp. is frequently established as part of skin and respiratory flora of hospitalized patients especially with prolonged periods, assessment of A. baumannii as etiology of disease or colonization is a particular challenge [9]. Bacterial typing either fenotype or genotype
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