An Outbreak of Carbapenem-ResistantAcinetobacter baumanniiInfection in a Neonatal Intensive Care Unit: Investigation and Control

Abstract

The spread of multidrug-resistant A. baumannii infection was suspected to be due to staff members who spread the pathogen through close contact with infants. Clinical staff recognition of the importance of multidrug-resistant A. baumannii recovery from neonatal intensive care unit patients, geographic cohorting of infected patients, enhanced infection control practices, and staff education resulted in control of the spread of the organism.

Literatur-Update zu Ausbrüchen auf neonatologischen Intensivpflegestationen – Serratia marcescens, Klebsiella pneumoniae, Acinetobacter baumannii und Pseudomonas aeruginosa

“…Die hier relevanten Erreger nosokomialer Infektionen können, wie mehrere der hier besprochenen Berichte zeigen [29,31,32], in der unbelebten Umgebung der Patienten persistieren [52]. Daher sollten vom Hygienefachpersonal gezielt eingesetzte Umgebungsuntersuchungen und eine Überprüfung und ggf.…”

Quarantine, Isolation, and Cohorting: From Cholera toKlebsiella

“…This has proved effective for disrupting outbreaks of MRSA [21,22,26,27], VRE [38,39,[41][42][43], ESBL-producing K. pneumoniae [30,[32][33][34], S. marcescens [44], Acinetobacter baumannii [31,[45][46][47], and P. aeruginosa [48].…”

“…Ten years later, a large Veterans Affairs medical center controlled a large MRSA outbreak with an isolated ward staffed with a dedicated medical team [22]. This same single-unit isolation cohorting has been successful in other settings, including outbreaks of neonatal ICU-acquired A. baumannii with the establishment of a separate cohort nursery; VRE by implementing a hospital ward capable of providing various levels of care, including intensive care to rehabilitation for infected patients; and finally for carbapenem-resistant K. pneumoniae by cohorting patients infected or colonized into a single unit with a dedicated nursing staff [34,41,47].…”

“…Nearly ubiquitous to all outbreaks is the initial failure of standard isolation precautions, universal screening of new admissions, and the cohorting of nursing, ancillary staff, and patient care equipment [21,26,30,31,33,34,41,[45][46][47]50]. Other methods of outbreak control are unit closure [21,30,[42][43][44]48], hiring of additional staff or an infectious disease consultant [22,44], encouraging use of disposable equipment [42], and screening of staff and subsequent reassignment of those colonized to non-clinical duties [15,30,48].…”

The whole genome sequencing of Acinetobacter-calcoaceticus-baumannii complex strains involved in suspected outbreak in an Intensive Care Unit of a pediatric hospital

“…Indeed, Acinetobacter baumannii is recovered in ventilator-associated pneumonia, catheter-related and wound infections particularly in patients admitted in UTI-Intensive Care Unit (UTI). [3][4][5][6] Furthermore, it is intrinsically resistant to many antimicrobial agents and frequently acquires genetic elements conferring multi-drug resistance (MDR). [7][8][9] Acinetobacter baumannii is resistant to desiccation and to disinfectants, it is difficult to be treated and to be eradicated and it requires rigorous monitoring programs to prevent and control hospital outbreaks.…”