title: Spread of multidrug carbapenem-resistant Acinetobacter baumannii in different wards of an Italian hospital.
abstract: BACKGROUND
  Multidrug-resistant Acinetobacter baumannii (MDRAB) is an important cause of hospital acquired infection. We describe a 7-month outbreak of a MDRAB infection involving various wards of an Italian hospital and an investigation of the possible source of the infection was conducted.
  
  
  METHODS
  A baumannii was isolated from various biological samples from 22 colonized or infected patients, and was identified and characterized for its antibiotic sensitivity. Typing of A baumannii was performed by multilocus sequence typing (MLST). Investigation of the outbreak involved extensive microbiological sampling of the environment.
  
  
  RESULTS
  In 50% of cases the infection occurred in the ICU. Invasive procedures were performed in 63.6% of patients. The strain isolated proved to be resistant to all the antibiotics tested, including carbapenems, and displayed the same allelic profile in all patients. None of the 141 samples taken during environmental monitoring showed positivity for A baumannii.
  
  
  CONCLUSIONS
  The results of the present study reveal the importance of strict adherence to control measures by all health care personnel and highlight the fact that regular staff training and frequent revision of control measures are essential to the successful management of an outbreak.
authors.affiliation: Department of Health Sciences, University of Genoa, Italy. cristinaml@unige.it
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Cristina
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Spagnolo
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ottria
authors.forename: Marina
authors.initials: M
authors.lastname: Sartini
authors.forename: Paolo
authors.initials: P
authors.lastname: Orlando
authors.forename: Fernanda
authors.initials: F
authors.lastname: Perdelli
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D005260:Female; D006761:Hospitals; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D055815:Young Adult; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems