Carbapenem-Resistant Acinetobacter baumannii: Concomitant Contamination of Air and Environmental Surfaces

Abstract

OBJECTIVE To concomitantly determine the differential degrees of air and environmental contamination by Acinetobacter baumannii based on anatomic source of colonization and type of ICU layout (single-occupancy vs open layout). DESIGN Longitudinal prospective surveillance study of air and environmental surfaces in patient rooms. SETTING A 1,500-bed public teaching hospital in Miami, Florida. PATIENTS Consecutive A. baumannii-colonized patients admitted to our ICUs between October 2013 and February 2014. METHODS Air and environmental surfaces of the rooms of A. baumannii-colonized patients were sampled daily for up to 10 days. Pulsed-field gel electrophoresis (PFGE) was used to type and match the matching air, environmental, and clinical A. baumannii isolates. RESULTS A total of 25 A. baumannii-colonized patients were identified during the study period; 17 were colonized in the respiratory tract and 8 were colonized in the rectum. In rooms with rectally colonized patients, 38.3% of air samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 13.1% of air samples were positive (P=.0001). In rooms with rectally colonized patients, 15.5% of environmental samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 9.5% of environmental samples were positive (P=.02). The rates of air contamination in the open-layout and single-occupancy ICUs were 17.9% and 21.8%, respectively (P=.5). Environmental surfaces were positive in 9.5% of instances in open-layout ICUs versus 13.4% in single-occupancy ICUs (P=.09). CONCLUSIONS Air and environmental surface contaminations were significantly greater among rectally colonized patients; however, ICU layout did not influence the rate of contamination. Infect Control Hosp Epidemiol 2016;37:777-781.

The role of hospital environment in transmissions of multidrug-resistant gram-negative organisms

“…Air and environmental surface contamination were significantly higher among rectally colonized patients compared to patients with respiratory colonization (38.3% vs 13.1 and 15.5% vs 5.5% respectively), which was explained by the use of closed-circuit ventilation in an ICU study [65]. Not surprisingly, air closest to patients contained higher concentrations of the organism [66].…”

“…All reported studies were conducted in adult patients and organisms implicated were CRAB and Pseudomonas species [60][61][62][63][64][65][66]. Majority of the studies were conducted in ICUs [61,63,64,66], one included ICU and step down medical wards [62], and the other was carried out in open wards [60].…”

“…Majority of the studies were conducted in ICUs [61,63,64,66], one included ICU and step down medical wards [62], and the other was carried out in open wards [60]. In all studies, the air sampling methods differed as some used passive method [61,63,65] while others used the active process [60,62,64,66]. Majority of the studies found A. baumannii.…”

Bacteria contamination of touch surfaces in polish hospital wards

“…The method of multiplication bacteria expected in environmental samples was also used by Shimose et. al [32] in the study on Acinetobacter baumannii contamination of air and hospital environmental surfaces.…”

Multidrug-resistant Gram-negative bacteria from patients, hospital environment and healthcare workers: a six-month cross-sectional study

“…Giving the inclusion criteria applied in our study, more than 90% of the patients presented a HAI-related GNB. We found several cases where the same GNB species (with similar or equal resistance profile) was identified in samples from the patients and their room, suggesting a cross contamination and demonstrating the importance of the hospital environment in the HAI dissemination (11, 22-25). Patients rectal swabs were the site with the highest positivity, followed by nasal and hands swabs.…”