Nosocomial Outbreak of Carbapenem-Resistant Acinetobacter baumannii in Intensive Care Units and Successful Outbreak Control Program.
10.3346/jkms.2010.25.7.999
- Author:
Won Suk CHOI
1
;
Su Hyun KIM
;
Eun Gyong JEON
;
Myeung Hee SON
;
Young Kyung YOON
;
Jung Yeon KIM
;
Mi Jeong KIM
;
Jang Wook SOHN
;
Min Ja KIM
;
Dae Won PARK
Author Information
1. Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. pugae1@korea.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Acinetobacter baumannii;
Disease Outbreaks;
Infection Control
- MeSH:
*Acinetobacter Infections/drug therapy/epidemiology/prevention & control;
Acinetobacter baumannii/isolation & purification/metabolism/*pathogenicity;
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Anti-Bacterial Agents/*therapeutic use;
Child;
Child, Preschool;
*Cross Infection/drug therapy/epidemiology/prevention & control;
*Drug Resistance, Multiple, Bacterial;
Hospitals, University;
Humans;
Infant;
Infection Control/*methods;
*Intensive Care Units;
Korea/epidemiology;
Male;
Middle Aged;
Young Adult
- From:Journal of Korean Medical Science
2010;25(7):999-1004
- CountryRepublic of Korea
- Language:English
-
Abstract:
Acinetobacter baumannii has been increasingly reported as a significant causative organism of various nosocomial infections. Here we describe an outbreak of carbapenem-resistant A. baumannii (CRAB) in the ICUs of a Korean university hospital, along with a successful outbreak control program. From October 2007 through July 2008, CRAB was isolated from 57 ICU patients. Nineteen patients were diagnosed as being truly infected with CRAB, four of whom were presumed to have died due to CRAB infection, producing a case-fatality rate of 21.1%. In surveillance of the environment and the healthcare workers (HCWs), CRAB was isolated from 24 (17.9%) of 135 environmental samples and seven (10.9%) of 65 HCWs. The pulsed field gel electrophoresis patterns showed that the isolates from patients, HCWs, and the environment were genetically related. Control of the outbreak was achieved by enforcing contact precautions, reducing environmental contamination through massive cleaning, and use of a closed-suctioning system. By August 2008 there were no new cases of CRAB in the ICUs. This study shows that the extensive spread of CRAB can happen through HCWs and the environmental contamination, and that proper strategies including strict contact precautions, massive environmental decontamination, and a closed-suctioning system can be effective for controlling CRAB outbreaks.
