title: Investigation of an outbreak of multidrug-resistant Acinetobacter baumannii in trauma intensive care unit.
abstract: Between January and June 2002, an outbreak of multidrug-resistant Acinetobacter baumannii occurred in a trauma intensive care unit (TICU) at the Hamad Medical Corporation, Qatar. The outbreak involved 21 patients whose infection/colonization was hospital acquired. All the strains were resistant to all tested antibiotics except amikacin. An A. baumannii strain with a similar antibiogram was isolated from the environment, equipment and hands of healthcare workers (HCWs). The technique of open suctioning probably resulted in aerosilization and contamination of the immediate patient environment. This allowed the hands of HCWs to be contaminated with the outbreak strain, with subsequent transmission to other patients and their environment. Lack of proper hand hygiene between patients and equipment contact facilitated this transmission. A review of hand hygiene practices, extensive environmental cleaning, a closed suctioning system, education and review of other infection-control practices, contributed to the termination of the outbreak.
authors.affiliation: Department of Laboratory Medicine and Pathology, Division of Microbiology, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar. sittana@hmc.org.qa
authors.forename: S S
authors.initials: SS
authors.lastname: El Shafie
authors.forename: M
authors.initials: M
authors.lastname: Alishaq
authors.forename: M
authors.initials: M
authors.lastname: Leni Garcia
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D004866:Equipment Contamination; D006235:Hand Disinfection / Q000592:standards*; D006769:Hospitals, General; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D011780:Qatar / Q000453:epidemiology; D013396:Suction / Q000009:adverse effects / Q000295:instrumentation; D014194:Traumatology
chemical_list: D000900:Anti-Bacterial Agents