Molecular findings and antibiotic-resistance in an outbreak of Acinetobacter baumannii in an intensive care unit.
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.
Longo
Benedetta
B
Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate,Istituto Superiore di Sanità, Rome, Italy.
Pantosti
Annalisa
A
Luzzi
Ida
I
Tarasi
Agapito
A
Di Sora
Fiorella
F
Gallo
Stella
S
Placanica
Paola
P
Monaco
Monica
M
Dionisi
Anna Maria
AM
Volpe
Italo
I
Montella
Francesco
F
Cassone
Antonio
A
Rezza
Giovanni
G
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
D000900:Anti-Bacterial Agents; D015780:Carbapenems; C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam; D012293:Rifampin; D003091:Colistin