Highlights
- •We describe an extensively drug-resistant Acinetobacter baumannii outbreak cross-transmitted between an intensive care unit and respiratory intensive care unit.
- •The laminar flow system connecting the intensive care unit and respiratory intensive care unit was the source of transmission.
- •The outbreak terminated after thorough cleaning, including the laminar flow system.
Background
Extensively drug-resistant Acinetobacter baumannii (XDRAB) is a great threat in intensive care units (ICUs). The aim of this study was
to describe an XDRAB outbreak which was cross-transmitted in the ICU and respiratory
intensive care unit (RICU) in a tertiary care hospital from January-March 2013.
Methods
Patient and environmental surveillances were performed. Isolates were tested for antimicrobial
susceptibility. Genotypes were analyzed by multilocus sequence typing (MLST). A series
of enhanced strategies were implemented to control the outbreak.
Results
A total of 11 patients were infected by XDRAB strains during this outbreak. Three
patients in the ICU were found positive for XDRAB at the onset of the outbreak. Thereafter,
infections were detected in 6 patients in the RICU, followed by reappearance of this
strain in the ICU in 2 patients. All A baumannii strains isolated from patients and the environment were extensively drug resistant.
MLST revealed them as ST368. After 3 rounds of environmental screening and cleaning,
the laminar flow system connecting the ICU and RICU was found as the source of transmission.
Successful control of this outbreak was achieved through multifaceted intervention
measures.
Conclusions
This study suggested the importance of thorough surveillance and disinfection of the
environment, including concealed devices, in preventing the transmission of an outbreak.
Key Words
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Article info
Publication history
Published online: May 20, 2016
Footnotes
Funding/Support: This work was supported by the Research Fund of Xi'an Jiaotong University (DW081135K0000004).
Conflicts of Interest: None to report.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.