The Analysis of Risk Factor and Infection Control of Carbapenem-Resistant Acinetobacter baumannii in a Medical Intensive Care Unit.
- Author:
Song Mi MOON
;
Jun Seong SON
;
Hee Joo LEE
;
Hee Kyung CHUN
;
Mee La KIM
;
Mi Suk LEE
- Publication Type:Original Article
- Keywords:
Acinetobacter baumannii;
Carbapenem resistance;
Intensive care unit
- MeSH:
Acinetobacter;
Acinetobacter baumannii;
Anti-Bacterial Agents;
APACHE;
Case-Control Studies;
Compliance;
Disease Transmission, Infectious;
Disinfection;
Epidemiologic Studies;
Hand Hygiene;
Humans;
Infection Control;
Critical Care;
Intensive Care Units;
Length of Stay;
Medical Records;
Multivariate Analysis;
Respiration, Artificial;
Retrospective Studies;
Risk Factors;
Sputum;
Suction
- From:Korean Journal of Nosocomial Infection Control
2009;14(2):72-78
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: An epidemiologic study was performed after the outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit (MICU) from December 2006 to May 2007. METHODS: A retrospective case-control study was performed using the medical records of the patients. The case and control patients were compared for age, gender, total length of stay in MICU, prior carbapenem use, Acute Physiology and Chronic Health Evaluation II (APACH II) score, presence of central line, effect of mechanical ventilation, and sputum suction. Environmental and hand-washing studies were performed during the outbreak. RESULTS: Ten CRAB-affected patients and 29 controls were enrolled in this study. Univariate analysis showed that the age, total length of stay in MICU, presence of central line, and prior carbapenem use were associated with the CRAB outbreak. However, multivariate analysis showed that only prior carbapenem use was associated with the CRAB outbreak (odd ratio: 8.67, P=0.01). The outbreak disappeared after implementing a combined infection control strategy, including the sequential disinfection of MICU and strict compliance with cross-transmission prevention protocols. CONCLUSION: The use of carbapenem was associated with an increased risk of CRAB infection. This study suggests that the MICU contamination and infection transmission by health-care workers played a major role in the CRAB outbreak. Novel strategies such as restricted use of broad-spectrum antibiotics, strict hand hygiene, strict isolation of the patients, and MICU disinfection may be required to prevent the CRAB outbreak.
