Early detection and control of an Acinetobacter baumannii multi-resistant outbreak in a hospital in Quito, Ecuador

Abstract

Introduction: Acinetobacter baumannii (ABA) is an important opportunistic pathogen associated with high mortality rates in intensive care units (ICUs). An outbreak in the ICU of a secondary-level hospital in Quito, Ecuador, occurred during April and May 2015 and was successfully controlled. Methodology: Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) and repetitive element palindromic (REP)-PCR was conducted on all isolates recovered from patients, as well as environmental samples, to confirm the presence of an outbreak. A case-control study was conducted by comparing the clinical histories of the affected patients and of control patients present in the ICU during the outbreak period who did not present a positive culture for ABA. Results: Five patients were infected and two were colonized with the same clonal strain of ABA, which was also identified on the stethoscope and a monitor associated with an isolation room. Statistical analysis of case histories did not identify any additional risk factors, but the outbreak was initiated by one patient in the isolation room of the ICU who was infected with the outbreak strain. All patients who ocupied that room after the index case tested positive for at least one culture of ABA. The outbreak strain was found on the stethoscope, and a subclone was found on the monitor of that room. Conclusion: Having access to basic equipment will enable well-trained professionals to rapidly detect and initiate the control process of an outbreak, saving lives and money spent on nosocomial infection treatments.

Distribution and Genotyping of Aquatic Acinetobacter baumannii Strains Isolated from the Puzi River and Its Tributaries Near Areas of Livestock Farming

“…In previous studies, this organism has primarily been investigated in hospitals and the clinical environment. The results of these studies have consistently indicated that A. baumannii is widespread in nosocomial environments [4,17,43]. This organism also prefers to grow in humid conditions.…”

<p>Successful Incidences of Controlling Multidrug-Resistant, Extensively Drug-Resistant, and Nosocomial Infection <em>Acinetobacter baumannii</em> Using Antibiotic Stewardship, Infection Control Programs, and Environmental Cleaning at a Chinese University Hospital</p>

“…29 During nosocomial outbreaks, the colonization in the hospital environment was very important for the transmission of MDRAB, and environmental cultures revealed that numerous sites in ICUs were contaminated with MDRAB. 44 These reports suggested that the high incidence of MDRAB, XDRAB, and NIAB-ICU should be solved immediately, and the medical specialty must undertake most duties. 45 Early recognition and timely implementation of appropriate ICP were crucial in preventing outbreaks.…”

Risk Factors Associated with Mortality in Acinetobacter baumannii Infections: Results of a Prospective Cohort Study in a Tertiary Public Hospital in Guayaquil, Ecuador

“…In Latin America, several cases of Acinetobacter baumannii have been reported. The situation with Acinetobacter baumannii CRAB/XCRAB is especially worrying in developing countries like Ecuador, where hospital conditions and policies are not updated, increasing the nosocomial infection risk [ 18 ]. Here, we describe the healthcare-associated infections caused by Acinetobacter baumannii that were identified in different units at the Hospital Teodoro Maldonado Carbo (HTMC), Guayaquil, Ecuador.…”