BACKGROUND: Acinetobacter baumannii is an opportunistic pathogen that has become a major cause of concern, since it is a frequent cause of healthcare-associatedinfections (HAIs). The aim of the study was to describe the occurrence, themanagement 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 ofextensively drug-resistant A. baumannii (XDRAB).METHODS: Case-patient was defined as a patient with an healthcare-associatedinfection caused by an XDRAB isolate identified in a clinically significantculture. Environmental samples were collected from different surfaces. Theisolates were identified by typical Gram stain morphology, using the Vitek 2system (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 atadmission and was managed with strict isolation precautions until discharge. Fivepatients had a ventilator-associated pneumonia and two had a centralline-associated bloodstream infection. Of the environmental samples, 1 sampleobtained from the side of the bed of an infected patient yielded growth of XDRAB.Infection control measures were adopted. Rep-PCR analysis identified fourpatterns.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 complexmolecular pattern of the outbreak, which subsided in a short period of time dueto adherence to infection-control measures, confirming the fundamental role ofmolecular typing in the comprehension of outbreaks dynamics and of integratedcontrol interventions for the interruption of epidemic events.

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

Bianco A;Quirino A;Giordano M;Marano V;Rizzo C;Liberto MC;Pavia M
2016-01-01

Abstract

BACKGROUND: Acinetobacter baumannii is an opportunistic pathogen that has become a major cause of concern, since it is a frequent cause of healthcare-associatedinfections (HAIs). The aim of the study was to describe the occurrence, themanagement 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 ofextensively drug-resistant A. baumannii (XDRAB).METHODS: Case-patient was defined as a patient with an healthcare-associatedinfection caused by an XDRAB isolate identified in a clinically significantculture. Environmental samples were collected from different surfaces. Theisolates were identified by typical Gram stain morphology, using the Vitek 2system (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 atadmission and was managed with strict isolation precautions until discharge. Fivepatients had a ventilator-associated pneumonia and two had a centralline-associated bloodstream infection. Of the environmental samples, 1 sampleobtained from the side of the bed of an infected patient yielded growth of XDRAB.Infection control measures were adopted. Rep-PCR analysis identified fourpatterns.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 complexmolecular pattern of the outbreak, which subsided in a short period of time dueto adherence to infection-control measures, confirming the fundamental role ofmolecular typing in the comprehension of outbreaks dynamics and of integratedcontrol interventions for the interruption of epidemic events.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12317/9350
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