title: Early detection and control of an Acinetobacter baumannii multi-resistant outbreak in a hospital in Quito, Ecuador.
abstract: BACKGROUND
  Acinetobacter baumannii (ABA) is an important opportunistic pathogen associated with high mortality rates in intensive care units (ICUs). An outbreak in the ICU of a secondary-level hospital in Quito, Ecuador, occurred during April and May 2015 and was successfully controlled.
  
  
  METHODS
  Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) and repetitive element palindromic (REP)-PCR was conducted on all isolates recovered from patients, as well as environmental samples, to confirm the presence of an outbreak. A case-control study was conducted by comparing the clinical histories of the affected patients and of control patients present in the ICU during the outbreak period who did not present a positive culture for ABA.
  
  
  RESULTS
  Five patients were infected and two were colonized with the same clonal strain of ABA, which was also identified on the stethoscope and a monitor associated with an isolation room. Statistical analysis of case histories did not identify any additional risk factors, but the outbreak was initiated by one patient in the isolation room of the ICU who was infected with the outbreak strain. All patients who ocupied that room after the index case tested positive for at least one culture of ABA. The outbreak strain was found on the stethoscope, and a subclone was found on the monitor of that room.
  
  
  CONCLUSIONS
  Having access to basic equipment will enable well-trained professionals to rapidly detect and initiate the control process of an outbreak, saving lives and money spent on nosocomial infection treatments.
authors.affiliation: Zurita and Zurita Laboratories, Avenida de la Prensa, Quito, Ecuador. mcarges@gmail.com.
authors.forename: Monica
authors.initials: M
authors.lastname: Cartelle Gestal
authors.forename: Jeannete
authors.initials: J
authors.lastname: Zurita
authors.forename: Gabriela
authors.initials: G
authors.lastname: Gualpa
authors.forename: Cecibel
authors.initials: C
authors.lastname: Gonzalez
authors.forename: Ariane
authors.initials: A
authors.lastname: Paz Y Mino
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D004484:Ecuador / Q000453:epidemiology; D004783:Environmental Microbiology; D005260:Female; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult