Outbreak of a susceptible strain of Acinetobacter species 13 (sensu Tjernberg and Ursing) in an adult neurosurgical intensive care unit.
Between December 1999 and June 2000, an outbreak caused by Acinetobacter emerged on the neurosurgical intensive care unit of our hospital. It was shown using automated ribotyping using Eco RI and pulsed-field gel electrophoresis that the outbreak was caused by spread of a single strain, which was identified by ribotyping and amplified ribosomal DNA restriction analysis as Acinetobacter DNA group 13TU (sensu Tjernberg and Ursing). The outbreak strain, which showed no antibiotic resistance, was identified in 23 patients, five of whom developed an infection. The organism was also isolated from various environmental sites. Cross-transmission among patients continued despite contact isolation of colonized patients and reinforcement of basic disinfection procedures. Eventually, after implementation of additional stringent measures such as cohorting of positive patients and daily disinfection of the floor, the outbreak was brought under control. This study demonstrates that apart from Acinetobacter baumanii, Acinetobacter 13TU strains, even when they are fully susceptible, may cause outbreaks that are difficult to control. Correct identification to the species level of Acinetobacter by genotypic methods is necessary to get insight in the importance of the different Acinetobacter genomic species in hospital epidemiology.
van Dessel
H
H
Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, University Medical Centre, Utrecht, The Netherlands.
Kamp-Hopmans
T E M
TE
Fluit
A C
AC
Brisse
S
S
de Smet
A M G A
AM
Dijkshoorn
L
L
Troelstra
A
A
Verhoef
J
J
Mascini
E M
EM
D000150:Acinetobacter / Q000145:classification / Q000302:isolation & purification*; D000151:Acinetobacter Infections / Q000453:epidemiology*; D000328:Adult; D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D021521:Ribotyping / Q000379:methods