title: Outbreak of multiresistant OXA-24- and OXA-51-producing Acinetobacter baumannii in an internal medicine ward.
abstract: Here we describe the clinical, microbiological, epidemiological, and molecular characterization of an outbreak of multidrug-resistant Acinetobacter baumannii (MRAB) involving 5 patients admitted to the internal medicine ward of our hospital. Over a 6-week period, 5 MRAB isolates were recovered from 5 patients, including 1 with fatal meningitis, 3 with skin and soft tissue infections, and 1 with respiratory colonization. One sample obtained during environmental monitoring in the ward was A. baumannii-positive. According to the pulsed-field gel electrophoresis typing results, the strains isolated from all patients and the environmental sample belonged to a single clone, identified as ST79 by multilocus sequence typing. The blaOXA-24 and blaOXA-51 carbapenemases were detected in all isolates. Four patients died, but only the death of the meningitis patient was probably related to the A. baumannii infection. The infection source was probably the hands of the healthcare workers because the outbreak strain was isolated from the surface of a serum container. The results of the present study revealed the importance of strict adherence to control measures by all healthcare workers because the consequences of noncompliance can be very serious.
authors.affiliation: Sección de Microbiología, Hospital Universitario de Guadalajara, Guadalajara, Spain. danielt@sescam.jccm.es
authors.forename: Daniel
authors.initials: D
authors.lastname: Tena
authors.forename: Nora Mariela
authors.initials: NM
authors.lastname: Martínez
authors.forename: Jesús
authors.initials: J
authors.lastname: Oteo
authors.forename: David
authors.initials: D
authors.lastname: Sáez
authors.forename: Ana
authors.initials: A
authors.lastname: Vindel
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Azañedo
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Sánchez
authors.forename: Alfredo
authors.initials: A
authors.lastname: Espinosa
authors.forename: Juan
authors.initials: J
authors.lastname: Cobos
authors.forename: Rosario
authors.initials: R
authors.lastname: Sánchez
authors.forename: Ignacio
authors.initials: I
authors.lastname: Otero
authors.forename: Julia
authors.initials: J
authors.lastname: Bisquert
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000201:enzymology* / Q000302:isolation & purification; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D016172:DNA Fingerprinting; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006761:Hospitals; D006801:Humans; D007388:Internal Medicine; D008297:Male; D058885:Multilocus Sequence Typing; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases; C410345:beta-lactamase OXA-24; C577373:beta-lactamase OXA-51, Acinetobacter baumannii