title: Carbapenem-Resistant Acinetobacter baumannii: Concomitant Contamination of Air and Environmental Surfaces.
abstract: OBJECTIVE To concomitantly determine the differential degrees of air and environmental contamination by Acinetobacter baumannii based on anatomic source of colonization and type of ICU layout (single-occupancy vs open layout). DESIGN Longitudinal prospective surveillance study of air and environmental surfaces in patient rooms. SETTING A 1,500-bed public teaching hospital in Miami, Florida. PATIENTS Consecutive A. baumannii-colonized patients admitted to our ICUs between October 2013 and February 2014. METHODS Air and environmental surfaces of the rooms of A. baumannii-colonized patients were sampled daily for up to 10 days. Pulsed-field gel electrophoresis (PFGE) was used to type and match the matching air, environmental, and clinical A. baumannii isolates. RESULTS A total of 25 A. baumannii-colonized patients were identified during the study period; 17 were colonized in the respiratory tract and 8 were colonized in the rectum. In rooms with rectally colonized patients, 38.3% of air samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 13.1% of air samples were positive (P=.0001). In rooms with rectally colonized patients, 15.5% of environmental samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 9.5% of environmental samples were positive (P=.02). The rates of air contamination in the open-layout and single-occupancy ICUs were 17.9% and 21.8%, respectively (P=.5). Environmental surfaces were positive in 9.5% of instances in open-layout ICUs versus 13.4% in single-occupancy ICUs (P=.09). CONCLUSIONS Air and environmental surface contaminations were significantly greater among rectally colonized patients; however, ICU layout did not influence the rate of contamination. Infect Control Hosp Epidemiol 2016;37:777-781.
authors.affiliation: 1Department of Medicine,Miller School of Medicine,University of Miami,Miami,Florida.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Shimose
authors.affiliation: 2Department of Medicine,Keck School of Medicine,University of Southern California,Los Angeles,California.
authors.forename: Eriko
authors.initials: E
authors.lastname: Masuda
authors.affiliation: 3Department of Medicine,Weill Cornell Medical College,New York,New York.
authors.forename: Maroun
authors.initials: M
authors.lastname: Sfeir
authors.affiliation: 1Department of Medicine,Miller School of Medicine,University of Miami,Miami,Florida.
authors.forename: Ana
authors.initials: A
authors.lastname: Berbel Caban
authors.affiliation: 1Department of Medicine,Miller School of Medicine,University of Miami,Miami,Florida.
authors.forename: Maria X
authors.initials: MX
authors.lastname: Bueno
authors.affiliation: 4Department of Pathology,Miller School of Medicine,University of Miami,Miami,Florida.
authors.forename: Dennise
authors.initials: D
authors.lastname: dePascale
authors.affiliation: 5Department of Medicine,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors.forename: Caressa N
authors.initials: CN
authors.lastname: Spychala
authors.affiliation: 4Department of Pathology,Miller School of Medicine,University of Miami,Miami,Florida.
authors.forename: Timothy
authors.initials: T
authors.lastname: Cleary
authors.affiliation: 6Department of Surgery,Miller School of Medicine,University of Miami,Miami,Florida.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
authors.affiliation: 1Department of Medicine,Miller School of Medicine,University of Miami,Miami,Florida.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Kett
authors.affiliation: 5Department of Medicine,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Doi
authors.affiliation: 7Department of Medicine,Froedtert and the Medical College of Wisconsin,Milwaukee,Wisconsin.
authors.forename: L Silvia
authors.initials: LS
authors.lastname: Munoz-Price
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000391:Air Microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016521:Electrophoresis, Gel, Pulsed-Field; D004781:Environmental Exposure / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D010362:Patients' Rooms / Q000706:statistics & numerical data; D012007:Rectum / Q000382:microbiology; D012137:Respiratory System / Q000382:microbiology; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems