title: Is airborne transmission of Acinetobacter baumannii possible: A prospective molecular epidemiologic study in a tertiary care hospital.
abstract: Understanding the dynamics of aerial spread of Acinetobacter may provide useful information for production of effective control measurements. We investigated genetic relationships between air and clinical isolates of Acinetobacter baumannii in an intensive care unit (ICU) setting.
  
  
  
  We conducted a prospective surveillance study in a tertiary care hospital for 8 months. A total of 186 air samples were taken from 2 ICUs. Clonal characteristics of air isolates were compared with the prospective clinical strains and the previously isolated strains of ICU patients over a 23-month period.
  
  
  
  Twenty-six (11.4%) air samples yielded A baumannii, of which 24 (92.3%) isolates were carbapenem-resistant. The Acinetobacter concentration was the highest in bedside sampling areas of infected patients (0.39 CFU/m3). Air isolates were clustered in 13 genotypes, and 7 genotypes (including 18 air strains) were clonally related to the clinical strains of 9 ICU patients. One clone continued to be cultured over 27 days in ICU air, and air isolates could be clonally related to 7-week retrospective and approximately 15-week prospective clinical strains.
  
  
  
  The results of this study suggest that infected patients could spread significant amounts of Acinetobacter to ICU air. These strains could survive in air for some weeks and could likely still infect new patients after some months. Special control measurements may be required against the airborne spread of Acinetobacter in ICUs.
authors: Medical Microbiology Department, Inonu University Medical Faculty, Malatya, Turkey.
authors: Yusuf
authors: Y
authors: Yakupogullari
authors: Medical Microbiology Department, Inonu University Medical Faculty, Malatya, Turkey. Electronic address: botlu@yahoo.com.
authors: Baris
authors: B
authors: Otlu
authors: Infectious Diseases and Clinical Microbiology Department, Inonu University Medical Faculty, Malatya, Turkey.
authors: Yasemin
authors: Y
authors: Ersoy
authors: Medical Microbiology Department, Inonu University Medical Faculty, Malatya, Turkey.
authors: Cigdem
authors: C
authors: Kuzucu
authors: Infectious Diseases and Clinical Microbiology Department, Inonu University Medical Faculty, Malatya, Turkey.
authors: Yasar
authors: Y
authors: Bayindir
authors: Infectious Diseases and Clinical Microbiology Department, Inonu University Medical Faculty, Malatya, Turkey.
authors: Uner
authors: U
authors: Kayabas
authors: Inonu University Medical Faculty, Anesthesiology and Reanimation Department, Malatya, Turkey.
authors: Turkan
authors: T
authors: Togal
authors: Recep Tayyip Erdogan University, Medical Microbiology Department, Rize, Turkey.
authors: Canan
authors: C
authors: Kizilkaya
mesh_terms: D000151:Acinetobacter Infections / Q000382:microbiology* / Q000635:transmission*; D040981:Acinetobacter baumannii / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D000391:Air Microbiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D018562:Disease Transmission, Infectious; D006801:Humans; D007362:Intensive Care Units; D050296:Microbial Viability; D017720:Molecular Epidemiology; D058889:Molecular Typing; D011446:Prospective Studies; D062606:Tertiary Care Centers; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems
keywords: Aerial spread; Environmental sampling; Health care-associated infection; Intensive care unit