Nosocomial outbreak of infection with multidrug-resistant Acinetobacter baumannii in a medical center in Taiwan.
OBJECTIVE
To investigate a nosocomial outbreak of infection with multidrug-resistant (MDR) Acinetobacter baumannii in the intensive care units at China Medical University Hospital in Taiwan.


METHODS
Prospective outbreak investigation.


METHODS
Three intensive care units in a 2,000-bed university hospital in Taichung, Taiwan.


METHODS
Thirty-eight stable patients in 3 intensive care units, all of whom had undergone an invasive procedure, were enrolled in our study. Ninety-four A. baumannii strains were isolated from the patients or the environment in the 3 intensive care units, during the period from January 1 through December 31, 2006. We characterized A. baumannii isolates by use of repetitive extragenic palindromic-polymerase chain reaction (REP-PCR) and random amplified polymorphic DNA (RAPD) fingerprinting. The clinical characteristics of the source patients and the environment were noted.


RESULTS
All of the clinical isolates were determined to belong to the same epidemic strain of MDR A. baumannii by the use of antimicrobial susceptibility tests, REP-PCR, and RAPD fingerprinting. All patients involved in the infection outbreak had undergone an invasive procedure. The outbreak strain was also isolated from the environment and the equipment in the intensive care units. Moreover, an environmental survey of one of the intensive care units found that both the patients and the environment harbored the same outbreak strain.


CONCLUSIONS
The outbreak strain of A. baumannii might have been transmitted among medical staff and administration equipment. Routine and aggressive environmental and equipment disinfection is essential for preventing recurrent outbreaks of nosocomial infection with MDR A. baumannii.
Chang
Hui-Lan
HL
Department of Laboratory Medicine, China Medical University Hospital, and the Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan.
Tang
Chih-Hsin
CH
Hsu
Yuan-Man
YM
Wan
Lei
L
Chang
Ya-Fen
YF
Lin
Chiung-Tsung
CT
Tseng
Yao-Ru
YR
Lin
Ying-Ju
YJ
Sheu
Jim Jinn-Chyuan
JJ
Lin
Cheng-Wen
CW
Chang
Yun-Chieh
YC
Ho
Mao-Wang
MW
Lin
Chia-Der
CD
Ho
Cheng-Mao
CM
Lai
Chih-Ho
CH
D000046:Academic Medical Centers; D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D040981:Acinetobacter baumannii / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control / Q000635:transmission; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007362:Intensive Care Units; D013624:Taiwan / Q000453:epidemiology
D004269:DNA, Bacterial