title: Nosocomial outbreak of infection with multidrug-resistant Acinetobacter baumannii in a medical center in Taiwan.
abstract: 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.
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, and the Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Hui-Lan
authors.initials: HL
authors.lastname: Chang
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Tang
authors.forename: Yuan-Man
authors.initials: YM
authors.lastname: Hsu
authors.forename: Lei
authors.initials: L
authors.lastname: Wan
authors.forename: Ya-Fen
authors.initials: YF
authors.lastname: Chang
authors.forename: Chiung-Tsung
authors.initials: CT
authors.lastname: Lin
authors.forename: Yao-Ru
authors.initials: YR
authors.lastname: Tseng
authors.forename: Ying-Ju
authors.initials: YJ
authors.lastname: Lin
authors.forename: Jim Jinn-Chyuan
authors.initials: JJ
authors.lastname: Sheu
authors.forename: Cheng-Wen
authors.initials: CW
authors.lastname: Lin
authors.forename: Yun-Chieh
authors.initials: YC
authors.lastname: Chang
authors.forename: Mao-Wang
authors.initials: MW
authors.lastname: Ho
authors.forename: Chia-Der
authors.initials: CD
authors.lastname: Lin
authors.forename: Cheng-Mao
authors.initials: CM
authors.lastname: Ho
authors.forename: Chih-Ho
authors.initials: CH
authors.lastname: Lai
mesh_terms: 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
chemical_list: D004269:DNA, Bacterial