title: Outbreak of carbapenem-resistant Acinetobacter baumannii in the intensive care unit: a multi-level strategic management approach.
abstract: An outbreak of carbapenem-resistant Acinetobacter baumannii (CRAb) occurred in an interdisciplinary intensive care unit, affecting 10 patients. Within hours of recognition of the spread of CRAb an intervention team was instituted for collection of available data, decision-making, communication and monitoring of all interventions performed, including cohorting, temporary stop of admissions, staff education, and enforcement of infection control measures. An area was defined for cohortation of patients colonized with CRAb, with a separate nursing team and a second set of mobile equipment. New transmissions were no longer observed after only four days into the institution of enhanced infection control measures.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Klinikum Leverkusen, Leverkusen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Molter
authors.affiliation: Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany; German Center for Infection Research, partner site Cologne-Bonn, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Seifert
authors.affiliation: Department of Infectious Diseases and General Internal Medicine, Klinikum Leverkusen, Leverkusen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Mandraka
authors.affiliation: Department of Infection Control, Klinikum Leverkusen, Leverkusen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Kasper
authors.affiliation: Department of Cardiology and Intensive Care Medicine, Klinikum Leverkusen, Leverkusen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Weidmann
authors.affiliation: Synlab Laboratory Services, Leverkusen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hornei
authors.affiliation: Public Health Department of the City of Leverkusen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Öhler
authors.affiliation: Department of Cardiology and Intensive Care Medicine, Klinikum Leverkusen, Leverkusen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Schwimmbeck
authors.affiliation: Institute of Clinical Pharmacology, Klinikum Leverkusen, Leverkusen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Kröschel
authors.affiliation: Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany.
authors.forename: P G
authors.initials: PG
authors.lastname: Higgins
authors.affiliation: Department of Infectious Diseases and General Internal Medicine, Klinikum Leverkusen, Leverkusen, Germany; Department of Infection Control, Klinikum Leverkusen, Leverkusen, Germany. Electronic address: stefan.reuter@klinikum-lev.de.
authors.forename: S
authors.initials: S
authors.lastname: Reuter
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification*; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems
keywords: Infection control; Intensive care unit; Intervention; Management; Multidrug resistance; Transmission