title: Outbreak of multidrug-resistant Acinetobacter baumannii in an intensive care unit.
abstract: Acinetobacter baumannii is a ubiquitous microrganism often able to colonize and survive in different environments. Currently it is one of the most common pathogens responsible for nosocomial infections, including outbreaks, especially in long-term care facilities. The aim of this study was to show the results of an environmental investigation and genotyping analysis of multidrug-resistant Acinetobacter baumannii associated with an outbreak in an intensive care unit of a tertiary hospital located in Northern Sardinia, Italy. Positive cultures of MDR Acinetobacter baumannii were reported during the month of June 2012, after the collection of biological samples from ten patients. Acinetobacter baumannii was isolated during the following environmental investigation from the headboard of two beds. All the strains were genotyped by performing multiplex PCR to identify the presence of genes encoding carbapenemases. The results showed specific bands of bla(OXA-51-like) gene and of the bla(OXA-23-like) gene. PFGE highlighted minimal differences in genomic fingerprints, while the cluster analysis grouped the isolated microorganisms into two closely related clusters, characterized by Dice's similarity coefficient equal to 95.1%. MLST showed that the strains belonged to ST31. The results of the study highlight the need, especially in high-risk areas, to adopt strict hygiene practices, particularly hand hygiene, and to ensure an appropriate turnover of personal protective equipment, which could be responsible for the spread of biological agents, such as MDR Acinetobacter baumannii.
authors.affiliation: Department of Biomedical Sciences, Hygiene and Preventive Medicine, University of Sassari, Sassari, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Dettori
authors.forename: Andrea
authors.initials: A
authors.lastname: Piana
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Deriu
authors.forename: Paola
authors.initials: P
authors.lastname: Lo Curto
authors.forename: Andrea
authors.initials: A
authors.lastname: Cossu
authors.forename: Rosario
authors.initials: R
authors.lastname: Musumeci
authors.forename: Clementina
authors.initials: C
authors.lastname: Cocuzza
authors.forename: Vito
authors.initials: V
authors.lastname: Astone
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Contu
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sotgiu
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D004866:Equipment Contamination / Q000706:statistics & numerical data; D004865:Equipment and Supplies, Hospital / Q000382:microbiology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007558:Italy / Q000453:epidemiology; D008297:Male; D062606:Tertiary Care Centers / Q000706:statistics & numerical data