Nosocomial outbreak of carbapenem-resistant Acinetobacter baumannii in intensive care units and successful outbreak control program.
Acinetobacter baumannii has been increasingly reported as a significant causative organism of various nosocomial infections. Here we describe an outbreak of carbapenem-resistant A. baumannii (CRAB) in the ICUs of a Korean university hospital, along with a successful outbreak control program. From October 2007 through July 2008, CRAB was isolated from 57 ICU patients. Nineteen patients were diagnosed as being truly infected with CRAB, four of whom were presumed to have died due to CRAB infection, producing a case-fatality rate of 21.1%. In surveillance of the environment and the healthcare workers (HCWs), CRAB was isolated from 24 (17.9%) of 135 environmental samples and seven (10.9%) of 65 HCWs. The pulsed field gel electrophoresis patterns showed that the isolates from patients, HCWs, and the environment were genetically related. Control of the outbreak was achieved by enforcing contact precautions, reducing environmental contamination through massive cleaning, and use of a closed-suctioning system. By August 2008 there were no new cases of CRAB in the ICUs. This study shows that the extensive spread of CRAB can happen through HCWs and the environmental contamination, and that proper strategies including strict contact precautions, massive environmental decontamination, and a closed-suctioning system can be effective for controlling CRAB outbreaks.
Choi
Won Suk
WS
Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Kim
Su Hyun
SH
Jeon
Eun Gyong
EG
Son
Myeung Hee
MH
Yoon
Young Kyung
YK
Kim
Jung-Yeon
JY
Kim
Mi Jeong
MJ
Sohn
Jang Wook
JW
Kim
Min Ja
MJ
Park
Dae Won
DW
D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D040981:Acinetobacter baumannii / Q000302:isolation & purification / Q000378:metabolism / Q000472:pathogenicity*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D000900:Anti-Bacterial Agents