Abstract
VEB-1 extended-spectrum beta-lactamase-producing Acinetobacter baumannii was responsible for an outbreak in hospitals in France. A national alert was triggered in September 2003 when 4 hospitals reported clusters of A. baumannii infection with similar susceptibility profiles. Case definitions and laboratory guidelines were disseminated, and prospective surveillance was implemented; strains were sent to a single laboratory for characterization and typing. From April 2003 through June 2004, 53 hospitals reported 290 cases of A. baumannii infection or colonization; 275 isolates were bla(VEB-1)-positive and clonally related. Cases were first reported in 5 districts of northern France, then in 10 other districts in 4 regions. Within a region, interhospital spread was associated with patient transfer. In northern France, investigation and control measures led to a reduction of reported cases after January 2004. The national alert enabled early control of new clusters, demonstrating the usefulness of early warning about antimicrobial drug resist.
Highlights
During the past decade, nosocomial outbreaks of Acinetobacter baumannii have been described with increasing frequency, occurring mostly in intensive care units, burn units, and surgical wards [1,2]
The location of the blaVEB-1 gene on the chromosomes and integrons was identified [4,16]. One year after this outbreak was controlled, nosocomial infections with this A. baumannii strain reemerged in the same area and subsequently spread to hospitals located in other districts in France
In early September 2003, an alert was triggered through the national nosocomial infection notification system when, within a month, 4 hospitals in a single district (Nord) reported 5 clusters of A. baumannii infections with a similar susceptibility profile; all A. baumannii strains were confirmed positive for VEB-1
Summary
Nosocomial outbreaks of Acinetobacter baumannii have been described with increasing frequency, occurring mostly in intensive care units, burn units, and surgical wards [1,2]. The blaVEB-1 ESBL gene is located in a class 1 integron initially detected in Enterobacteriaceae and Pseudomonas aeruginosa from Southeast Asia [18,19,20] It has been described in clonally related A. baumannii isolates recovered during an outbreak that lasted 9 months (August 2001–April 2002) in the intensive care unit of a hospital in northern France [4,16]. In these strains, the location of the blaVEB-1 gene on the chromosomes and integrons was identified [4,16].
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