[Outbreak of multiresistant Acinetobacter baumannii infection].
BACKGROUND
Nosocomial infections caused by multiresistant gram-negative bacteria represent an increasing problem, especially among intensive care patients. A serious outbreak of infection caused by multi-resistant Acinetobacter baumannii occurred in four burn patients. Acinetobacter is a gram-negative coccibacilli which is widespread in nature, and has been reported as an increasing problem in critically ill patients.


METHODS
The outbreak strain was introduced from Alicante, Spain, by a transferred patient. This strain was resistant to all commonly available systemic antibiotics (including the karbapenems and all aminoglycosides), and sensitive only to polymyxin B. Two patients were critically ill, one of them died in septic shock.


RESULTS
The ward was closed for admission of new patients and hygiene precautions were strengthened. Extensive testing of staff and equipment revealed multi-resistant A baumannii on a shower trolley shared by several patients. The outbreak strain was also identified by restriction endonuclease analysis. The patients were kept strictly isolated until their burn wounds were sufficiently healed to allow them to be discharged to their homes.


CONCLUSIONS
Following discharge of the last patient and extensive cleaning and disinfection of the entire ward, the particularly resistant strain has not reoccurred. Still, this experience may warrant screening for multiresistant gram-negative rods in patients transferred from regions where broad resistance to antibiotics is a common problem.
Onarheim
H
H
Haukeland Sykehus, Bergen. henning.onarheim@haukeland.no
Høivik
T
T
Harthug
S
S
Digranes
A
A
Mylvaganam
H
H
Vindenes
H A
HA
D000150:Acinetobacter / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000188:drug therapy / Q000276:immunology / Q000635:transmission*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002056:Burns / Q000188:drug therapy / Q000382:microbiology*; D016638:Critical Illness; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D004196:Disease Outbreaks; D018432:Drug Resistance, Multiple; D017809:Fatal Outcome; D006757:Hospital Units; D006801:Humans; D017053:Infection Control; D009664:Norway; D010356:Patient Isolation; D013030:Spain; D014195:Travel; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents