Control of an epidemic spread of a multi-resistant strain of Acinetobacter calcoaceticus in a hospital

Abstract

The spread of a multi-resistant glucose-acidifying Acinetobacter calcoaceticus strain in a community hospital was studied. After admission of a colonized patient to the hospital the strain was found in clinical specimens from ICU patients and subsequently from several of these patients after transfer to medical wards. Environmental specimens from the ICU and medical wards were analysed in order to investigate the mode of spread of the strain. Isolates of A. calcoaceticus were screened by their antibiotic resistance pattern. In addition, the cell envelope protein electrophoretic profiles were used as epidemiological markers. The multi-resistant acinetobacters all had the same protein profile. To prevent spread of the epidemic strain strict hygienic measures were enforced, e.g. scrupulous cleaning of the room after discharge of any colonized patient and increased attention to the hand hygiene of the medical and nursing staff. Furthermore, the use of antibiotics was restricted. Although this strain was only eradicated with difficulty in the affected patients, it did not spread throughout the hospital. Colonization of patients with the multi-resistant micro-organism was predominantly localized to the ICU.