Outbreak of Multiresistant OXA-24- and OXA-51-Producing <i>Acinetobacter baumannii</i> in an Internal Medicine Ward

Abstract

SUMMARY:Here we describe the clinical, microbiological, epidemiological, and molecular characterization of an outbreak of multidrug-resistant Acinetobacter baumannii (MRAB) involving 5 patients admitted to the internal medicine ward of our hospital. Over a 6-week period, 5 MRAB isolates were recovered from 5 patients, including 1 with fatal meningitis, 3 with skin and soft tissue infections, and 1 with respiratory colonization. One sample obtained during environmental monitoring in the ward was A. baumannii-positive. According to the pulsed-field gel electrophoresis typing results, the strains isolated from all patients and the environmental sample belonged to a single clone, identified as ST79 by multilocus sequence typing. The bla OXA-24 and bla OXA-51 carbapenemases were detected in all isolates. Four patients died, but only the death of the meningitis patient was probably related to the A. baumannii infection. The infection source was probably the hands of the healthcare workers because the outbreak strain was isolated from the surface of a serum container. The results of the present study revealed the importance of strict adherence to control measures by all healthcare workers because the consequences of noncompliance can be very serious.

New PCR-Based Open Reading Frame Typing Method for Easy, Rapid, and Reliable Identification of Acinetobacter baumannii International Epidemic Clones without Performing Multilocus Sequence Typing

“…However, they cannot identify newly emerging multidrug-resistant epidemic clones that might spread in the future. In fact, multidrug-resistant isolates other than the A. baumannii international clones have been reported (12)(13)(14)(15)(16)(17)(18). The POT method constructed in the present study is applicable to the identification of new CCs of A. baumannii or A. calcoaceticus-A.…”

Detection of antibiotic resistant Acinetobacter baumannii in various hospital environments: potential sources for transmission of Acinetobacter infections

“…They concluded that environmental contamination has an important reservoir role in outbreaks of A. baumannii in ICUs. Results of Tena et al [ 25 ] showed that all five clinical isolates and one environmental isolate belonged to a single clone. Based on the clonal relationship of the isolates by pulsed-field gel electrophoresis (PFGE), they concluded that the infection source has probably been the hands of the healthcare workers [ 25 ].…”

“…Results of Tena et al [ 25 ] showed that all five clinical isolates and one environmental isolate belonged to a single clone. Based on the clonal relationship of the isolates by pulsed-field gel electrophoresis (PFGE), they concluded that the infection source has probably been the hands of the healthcare workers [ 25 ]. Similarly, Cicek et al [ 7 ] suggested that all the patients and environmental isolates were derived from a common source.…”

“…In the study of Gao et al [ 12 ], OXA-24 and −58 were not detected in any air isolates. Tena et al [ 25 ] detected OXA-24 carbapenemase in all five isolates from patients and one isolate from surface of a serum container. Conversely, studies in Italy reported the frequent isolation of OXA-58 producing A. baumannii [ 29 ].…”

Effectiveness of healthcare worker screening in hospital outbreaks with gram-negative pathogens: a systematic review

“…HCWs were considered to be the actual source of the nosocomial outbreak in 35 [ 10 – 44 ] of the 1002 reports (= 3.6%) by the authors of the articles. However, we had to exclude 10 [ 10 , 13 , 16 , 18 , 19 , 28 , 30 , 35 , 42 , 44 ] articles after full text reading because they either provided insufficient evidence, had a general lack of data, took place at facilities other than hospitals (e.g., long term care facilities), or did not focus on GNB in particular. The colonisation status of the HCWs in the remaining 25 articles were either transient (11 articles) or permanent (14 articles).…”