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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.