Abstract
BackgroundImipenem-resistant Acinetobacter baumannii (IRAB) is an important cause of hospital-acquired infection. We aimed to describe an outbreak of IRAB infection and to investigate its possible source in an intensive care unit.MethodsAn environmental investigation was undertaken. Antimicrobial susceptibility testing was performed by microdilution. These isolates were genotyped by use of repetitive extragenic palindromic polymerase chain reaction (rep-PCR; DiversiLab). The study included 11 patients infected with IRAB and 14 control patients free of IRAB. Case and control patients were compared for possible predisposing factors. A multifaceted intervention was implemented to control the outbreak.ResultsThirty-nine IRABs were isolated from patients and the environmental surveillance culture in August, November, and December 2011. All isolates were resistant to imipenem. The IRAB strains belonged to seven clones (A–G) by the use of rep-PCR. There were four epidemic clones (D–G) in the outbreak, and Clone D was predominant. For the case–control study, patients with chronic obstructive pulmonary disease were susceptible to infection with IRAB. The hospital mortality of the case group was significantly higher than that of the control group.ConclusionsThe outbreak strains were transmitted among infected patients and equipment by inappropriate use of gloves. A combination of aggressive infection control measures is essential for preventing recurrent nosocomial outbreaks of IRAB.
Highlights
Imipenem-resistant Acinetobacter baumannii (IRAB) is an important cause of hospital-acquired infection
On August 9, 2011, an outbreak of nosocomial infection with IRAB was noted in our medical Intensive care units (ICU)
Outbreak description In mid-August 2011, the Infection Control Department was notified that there was an outbreak of IRAB infection
Summary
Imipenem-resistant Acinetobacter baumannii (IRAB) is an important cause of hospital-acquired infection. We aimed to describe an outbreak of IRAB infection and to investigate its possible source in an intensive care unit. Acinetobacter baumannii, a non-fermenting Gram-negative bacterium, is recognized as an important opportunistic pathogen, and is associated with mortality in intensive care units (ICUs) [1]. The carbapenem group of antimicrobial agents is commonly used for treating nosocomial infections caused by A. baumannii [5]. Carbapenem resistance has been increasingly identified in the past decade [6,7], and imipenem-resistant A. baumannii (IRAB) has been increasingly reported as a cause of nosocomial outbreaks [8,9,10,11,12]. We isolated IRAB from clinical specimens and the hospital environment, using the DiversiLab repetitive extragenic palindromic sequence-based PCR (rep-PCR) to assess the genetic relationship of these resistant isolates
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