Look at handwashing of staff and of mothers.  We had an incident three years ago of triplets who had salmonella. No one else had it.  This was VERY expensive to follow through, but necessary.   Breast milk cultured positive for salmonella.  I had to do a clean catch of pumped breast milk with this mom several times.  Always her milk cultured negative when in the hospital.  Milk at home cultured positive for salmonella.  We did think of Munchausen's.  Mom, dad, primary nurses and docs were all tested for salmonella(and you know what that means!!!).  ALL NEGATIVE.  Gave mom a new set of pumping equipment, had her disinfect counter tops where she placed her equipment at home.  Milk cultures became negative.
Again, where is your milk prepared in the NICU????  At the bedside, in a common kitchen area???  Maybe the surface needs to be wiped down between users.  Again, look at the pumps.  Not just the insides--bacteria can be on the outside from touching.  After an outbreak of several unusual bacteria (Psuedomonas, serratia, e.coli & something else)we began having moms wash down the pumps with antiseptic wipes before using them.  What bacteria exactly grew out in the milk?  Gram negative makes me think of e.coli and enterobacter.  These are not normal skin flora.  Maybe someone(or everyone) needs to wash their hands better after using the toilet.  Good luck.  Maureen Allen RN, BSN, IBCLC, Brigham and Women's Hospital, Boston, MA

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