title: Successful Eradication of Multidrug Resistant Acinetobacter in the Helsinki Burn Centre.
abstract: Multidrug-resistant (MDR) Acinetobacter is an important pathogen implicated in nosocomial infections in healthcare environments. Virulence factors, resistance mechanisms, and limited therapeutic options make this pathogen a major problem currently facing burn intensive care units (ICUs) worldwide. The purpose of this study was to assess the effect of infection control measures taken in Helsinki Burn Centre in 2001 on MDR Acinetobacter prevalence in ICU burn patients. Data were retrospectively collected from patient files from 1998 to 2012. ICU burn patients were defined as those with either over 30% of total body surface area burnt or requiring mechanical ventilation. Inclusion criteria consisted of patients who tested positive for Acinetobacter sp. in routine bacterial cultures or cultures taken because of a clinically suspected infection. Infection control interventions performed in 2001 consisted of various shower room renovations and changes in hospital hygiene and burn treatment regimes. Between 1998 and 2012, 75 patients were diagnosed with Acinetobacter sp. colonization. Following the infection control interventions the incidence of Acinetobacter sp. radically declined. Between 1998 and 2001, there were 31 cases of MDR Acinetobacter colonizations diagnosed, but from 2002 to 2012 no MDR strains were found. Changes to hospital hygiene and wound treatment protocols as well as structural changes to the hospital environment can have a major impact on preventing and treating Acinetobacter outbreaks in burn centers.
authors.affiliation: From the *Helsinki Burn Centre, Helsinki University Central Hospitals, Finland; †Lohja Health Care Centre, Finland; and ‡Department of Medicine, Division of Infectious Diseases, Helsinki University Central Hospital, Finland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lindford
authors.forename: Valtteri
authors.initials: V
authors.lastname: Kiuru
authors.forename: Veli-Jukka
authors.initials: VJ
authors.lastname: Anttila
authors.forename: Jyrki
authors.initials: J
authors.lastname: Vuola
mesh_terms: D000150:Acinetobacter / Q000187:drug effects / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002053:Burn Units; D015331:Cohort Studies; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D016208:Databases, Factual; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents