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. 2016 Dec 12;16(1):747.
doi: 10.1186/s12879-016-2036-7.

Control of carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit of a teaching hospital in Southern Italy

Aida Bianco  1 , Angela Quirino  1 , Mariavalentina Giordano  1 , Vito Marano  1 , Claudia Rizzo  1 , Maria Carla Liberto  1 , Alfredo Focà  1 , Maria Pavia  2
Affiliations

Control of carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit of a teaching hospital in Southern Italy

Aida Bianco et al. BMC Infect Dis. .

Abstract

Background: Acinetobacter baumannii is an opportunistic pathogen that has become a major cause of concern, since it is a frequent cause of healthcare-associated infections (HAIs). The aim of the study was to describe the occurrence, the management and the control of an outbreak that occurred in an intensive care unit (ICU) of a teaching hospital in Southern Italy caused by multiple strains of extensively drug-resistant A. baumannii (XDRAB).

Methods: Case-patient was defined as a patient with an healthcare-associated infection caused by an XDRAB isolate identified in a clinically significant culture. Environmental samples were collected from different surfaces. The isolates were identified by typical Gram stain morphology, using the Vitek 2 system (bioMérieux, France) and by MALDI-TOF MS mass spectrometry (bioMèrieux, France). Genotyping was performed through rep-PCR analysis.

Results: A patient presented an XDRAB ventilator-associated pneumonia at admission and was managed with strict isolation precautions until discharge. Five patients had a ventilator-associated pneumonia and two had a central line-associated bloodstream infection. Of the environmental samples, 1 sample obtained from the side of the bed of an infected patient yielded growth of XDRAB. Infection control measures were adopted. Rep-PCR analysis identified four patterns.

Conclusions: The integration of epidemiological and microbiological data and the application of infection control measures were crucial to bring such an outbreak to a rapid halt. The distinctive characteristic of this study was the complex molecular pattern of the outbreak, which subsided in a short period of time due to adherence to infection-control measures, confirming the fundamental role of molecular typing in the comprehension of outbreaks dynamics and of integrated control interventions for the interruption of epidemic events.

Keywords: Acinetobacter baumannii; Extensively drug resistance; Infection control; Intensive care unit; Outbreak; Rep-PCR.

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Figures

Fig. 1
Fig. 1
Chronogram. Distribution of XDRAB positive patients as a function of time and ward
Fig. 2
Fig. 2
Dendrogram plot. Results of molecular typing of A. baumannii isolates and percentage of similarity
See this image and copyright information in PMC

References

    1. Kallen AJ, Hidron AI, Patel J, Srinivasan A. Multidrug resistance among gram-negative pathogens that caused healthcare-associated infections reported to the National Healthcare Safety Network, 2006–2008. Infect Control Hosp Epidemiol. 2010;31:528–31. doi: 10.1086/652152. - DOI - PubMed
    1. Antimicrobial resistance surveillance in Europe. Annual report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). 2014. http://ecdc.europa.eu/en/healthtopics/antimicrobial-resistance-and-consu.... Accessed 16 Nov 2015.
    1. Antibiotic resistance threats in the United States, 2013. CDC. http://www.cdc.gov/drugresistance/threat-report-2013/. Accessed 17 Jul 2014.
    1. Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis. 2006;42:692–9. doi: 10.1086/500202. - DOI - PubMed
    1. Wendt C, Dietze B, Dietze E, Ruden H. Survival of Acinetobacter baumannii on dry surfaces. J Clin Microbiol. 1997;35:1394–7. - PMC - PubMed

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