title: Molecular findings and antibiotic-resistance in an outbreak of Acinetobacter baumannii in an intensive care unit.
abstract: We investigated an outbreak of Acinetobacter baumannii in the intensive care unit (ICU) of a hospital in Rome, Italy. The outbreak involved 14 patients whose isolates were most frequently recovered from bronchoalveolar lavage. All isolates were multidrug-resistant and showed diminished susceptibility or resistance to carbapenems. A. baumannii strains with a similar antibiotic susceptibility pattern were isolated from the environment. Pulsed-field gel electrophoresis identified a single clone from both the patients' and environmental isolates. Because of the lack of a single source of infection, the eradication of the epidemic required a broad approach, including contact isolation and cohorting, aggressive environmental disinfection, and close monitoring of the ward staff's performance. Infected patients were successfully treated with combined therapy. Although considered of low virulence, A. baumannii can be particularly aggressive and difficult to treat in ICU patients.
authors.affiliation: Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate,Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Longo
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pantosti
authors.forename: Ida
authors.initials: I
authors.lastname: Luzzi
authors.forename: Agapito
authors.initials: A
authors.lastname: Tarasi
authors.forename: Fiorella
authors.initials: F
authors.lastname: Di Sora
authors.forename: Stella
authors.initials: S
authors.lastname: Gallo
authors.forename: Paola
authors.initials: P
authors.lastname: Placanica
authors.forename: Monica
authors.initials: M
authors.lastname: Monaco
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Dionisi
authors.forename: Italo
authors.initials: I
authors.lastname: Volpe
authors.forename: Francesco
authors.initials: F
authors.lastname: Montella
authors.forename: Antonio
authors.initials: A
authors.lastname: Cassone
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rezza
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D015780:Carbapenems / Q000494:pharmacology; D003091:Colistin / Q000008:administration & dosage / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D004203:Disinfection; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use; D012384:Rome / Q000453:epidemiology; D013407:Sulbactam / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam; D012293:Rifampin; D003091:Colistin