In addition to the definitions in Chapter 3, in a neonatal unit investigation by IPCT is also required if:

• a single case of Pseudomonas aeruginosa is identified
• a single case of infection with an alert organism is identified
• two or more cases of colonisation with the same organism; linked in time and place are identified

Additionally, the local IPC team should consider the possibility of any onward transmission and potential for an incident/outbreak where there is:

• A single case of colonisation with an alert organism identified

Assigning a dedicated team to care for infected or colonised neonates may also be required. During outbreaks or incidents the ratio of staff to neonates may need to increase and it may be necessary to restrict admissions to the area. Prior to closing or restricting a neonatal unit, communication must be agreed across neonatal services and risk assessed.

Transfers to other units during incidents or outbreaks should be avoided, where possible; however this should take into consideration the clinical needs of neonates, and any practical or logistical issues for parents/carers.