Page 305 - Abstract Book KONIKA 18

Neonatology

P-NEO-035
Outbreak Investigation of Acinetobacter baumannii Infection
in NICU in Soeradji Tirtonegoro Hospital, Klaten, Central Java

Vincencius William , Samad Samad , Muslikhah Yuni Farkhati 2
1
2
Department of Pediatrics, Dr. Sardjito Hospital/ Faculty of Medicine, Public Health and Nursing, Universitas Gadjah
1
2
Mada, Yogyakarta and Soeradji Tirtonegoro General Hospital, Klaten , Central Java, Indonesia
Abstract
Background Acinetobacter baumannii is a Gram-negative bacterium associated with hospital-acquired
infection (HAI) and high mortality rates in neonatal intensive care unit (NICU) worldwide. Eight cases
of outbreak investigation in NICU had been reported worldwide since 2004 to 2017 and mortality rate in
neonates ranged from 0% to 72%. Objective To investigate the potential source of transmission in an outbreak
of Acinetobacter baumannii. Methods This descriptive study was conducted in Soeradji Tirtonegoro General
Hospital, Klaten, Central Java. The inclusion criteria were Acinetobacter baumannii blood culture-proven
sepsis in patients admitted to the NICU at our hospital from February 2021 to June 2021, and the exclusion
criteria were incomplete medical record. Environmental sampling was conducted in June, which included
high-touch surfaces, water, and air. The sampling produced 56 environmental samples. The samples were
processed using MacConkey agar and blood agar in a microbiology laboratory. Results There were six
cases of Acinetobacter baumannii septicaemia. Mean birthweight, gestational age, and age at the time of the
isolation of Acinetobacter baumannii was 1,627.5 (SD 439) grams, 32.8 (SD 2.4) weeks, and 12.1 (4.8) days.
In four cases, carbapenem-resistant Acinetobacter baumannii was found. Mortality rate of sixty-six percent
was observed in this study. Environmental samples of Acinetobacter baumannii were found in incubators,
beds, and incubator water. Conclusion A rapid and thorough environmental investigation is essential to
identify the source of the infection. Contaminated equipment and transmission via health care workers are
potential routes of transmission.
Keywords: aeonates; Acinetobacter baumannii; NICU

P-NEO-036
Classical Vitamin K Deficiency Bleeding in Unwanted Pregnancy: A Case Report

Made Yuliantari Dwi Astiti, I Kadek Suarca
Departement of Child Health, Wangaya Hospital, Bali Jimbaran Hospital, Bali, Indonesia
Abstract
Background Vitamin K Deficiency Bleeding (VKDB) is bleeding condition due to inadequate activity of
coagulation factors related to vitamin K (II, VII, IX and X). Classical VKDB occur in days 1-7 after delivery
with the common risk factor are associated with low Vitamin K content in breast milk and inadequate
vitamin K prophylaxis. Objective To demonstrate a case of classical VKDB in an unwanted pregnancy
which may related to lack of maternal dietary vitamin K and supplementation due to no antenatal care visit.
Case A 2-days-age Caucasian boy, 3160 g was admitted to Hospital with profuse hematemesis and
haematochezia. He was delivered 3340 g per vaginam, aterm and had injected 1 mg intramuscular vitamin
K prophylaxis at birth. He was exclusively breastfed. The mother never had any antenatal care due to her
unwanted pregnancy. At admission he was conscious, weak and anemic on both eyes with vital sign within
normal limit. Blood test showed an anemia (Hb 10.1 g/dL) and prolonged prothrombin time (26.9). A classical
VKDB was suspected. Intravenous Vitamin K 2 mg was administered for 3 days, also blood transfusion due
to low hemoglobin level. During hospitalization, he was not presented further bleeding and discharged with
good condition also normal laboratory limit. Conclusion VKDB in infant who already had VK prophylaxis
is a rare condition due to lack VK level in breastmilk and infant cord. It is important to maintain adequate
maternal intakes of VK during pregnancy.
Keywords: vitamin K deficiency bleeding; unwanted pregnancy

KONIKA XVIII Abstract Book 257