Outbreak of Multi-resistant Acinetobecter baumannii in Intensive Care Unit of a Newly Opened Hospital.
- Author:
Hyun Joo PAI
1
;
Sun Mi YOO
;
Yeon Sun SEONG
;
So Hee SONH
;
Yun Kyoong CHO
;
Jung Han SONG
;
Jeong Hee CHO
;
Hak Choong LEE
Author Information
1. Department of Internal Medicine, Dankook University Medical College, Cheonan, Korea.
- Publication Type:Original Article
- Keywords:
Acinetobacter baumannli;
Nosocomial outbreak;
Multi-drug resistance;
Ribotyping
- MeSH:
Acinetobacter baumannii;
Amikacin;
Case-Control Studies;
Catheterization, Central Venous;
Catheters;
Central Venous Catheters;
Colon;
Drug Resistance, Multiple;
Humans;
Intensive Care Units*;
Critical Care*;
Logistic Models;
Microbial Sensitivity Tests;
Pneumonia;
Retrospective Studies;
Ribotyping;
Risk Factors;
Sepsis;
Wound Infection
- From:Korean Journal of Nosocomial Infection Control
1996;1(1):49-61
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: A sustained outbreak of multi-resistant Acinetobacter baumannii has been noticed in intensive care unit (ICU) of a newly opened hospital. METHODS: We retrospectively studied 72 patients in the ICU whose specimen grew A. baumannii from March to December 1995. To identify risk factors for infection, a case control study was conducted. Comparing clinical characteristics of 19 infected patients with those of 53 colonized cases. Environmental culture was performed in January 1996 to identify the source of infection. We analyzed antibiotic susceptibility of the isolates, and ribotyping was performed with 52 isolates. RESULTS: Nineteen out of 72 patients developed disease: primary sepsis 2, catheter related infection 2, catheter related infection and pneumonia 2, wound infection 5, wound infection and sepsis 2, pneumonia 6. On comparison of clinical characteristics between the infected and colonized groups, central venous catheterization was a significant risk factor for development of disease by A. baumannii (P<0.05) and duration of lCU stay was a factor independently associated with A. baumannii infection by logistic regression analysis. An epidemiologic investigation failed to identify the source of infection, but we found 2 of 3 sinks in lCU were heavily contaminated by the organism. Antibiogram of the isolates showed a multi-drug resistance including amikacin, which was found to increase gradually during the course of the outbreak. Ribotyping showed 3 major subtypes: 2A (18 isolates) 2B (16) 2B'(13) and other types (5). CONCLUSION: The findings from this study support the reports from many parts of the world that A. baumannii plays an increasingly important role as one of the major nosocomial pathogens.
