Role of environmental cleaning in controlling an outbreak of Acinetobacter baumannii on a neurosurgical intensive care unit

Denton, M.; Wilcox, Mark H.; Parnell, P.; Green, D.; Keer, V.; Hawkey, Peter M.; Evans, Idris; Murphy, Paul

doi:10.1016/j.iccn.2003.10.008

Cited by 67 publications

(52 citation statements)

References 19 publications

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“…Many hospitals have included this kind of analysis among the measures taken to eradicate outbreaks (8,15,26,29). This work shows that typing studies provide information about time-clonal distribution in different hospital wards and the clonal complexity of outbreaks.…”

Section: Discussionmentioning

confidence: 94%

Clonal Diversity of Nosocomial Epidemic Acinetobacter baumannii Strains Isolated in Spain

et al. 2011

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Acinetobacter baumannii is one of the major pathogens involved in nosocomial outbreaks. The clonal diversity of 729 epidemic strains isolated from 19 Spanish hospitals (mainly from intensive care units) was analyzed over an 11-year period. Pulsed-field gel electrophoresis (PFGE) identified 58 PFGE types that were subjected to susceptibility testing, rpoB gene sequencing, and multilocus sequence typing (MLST). All PFGE types were multidrug resistant; colistin was the only agent to which all pathogens were susceptible. The 58 PFGE types were grouped into 16 clones based on their genetic similarity (cutoff of 80%). These clones were distributed into one major cluster (cluster D), three medium clusters (clusters A, B, and C), and three minor clusters (clusters E, F, and G). Multidrug-resistant Acinetobacter baumannii is a bacterium frequently endemic in certain hospital wards and is responsible for numerous nosocomial outbreaks around the world (3,23,33). Its great capacity to survive in low-moisture environments and its ability to develop resistance to antimicrobial agents afford A. baumannii the possibility of spreading in hospitals. The skin, oropharynx, and digestive tract are the main body areas colonized in hospitalized patients. The risk of colonization and subsequent infection are associated with factors such as the presence of underlying severe illnesses, long-term hospitalization, stays in specific hospital wards, selective antimicrobial pressure, and invasive interventions such as the use of mechanical ventilation or catheters (4,12,14,18).Nosocomial outbreaks of A. baumannii can have their origin in a single reservoir or in multiple contaminated sites (37, 39), and infection can have serious repercussions for patient morbidity and mortality. Patients can acquire the bacterium from an environmental source or from other patients (6, 18).The clonal study of hospital strains is very important in terms of an understanding of the epidemiology of these outbreaks. The aim of the present work was therefore to analyze the genetic diversity and clonal distribution of epidemic strains of A. baumannii isolated from around Spain over a long period of time. Isolates collected during outbreaks at different hospitals were analyzed by pulsed-field gel electrophoresis (PFGE), sequencing of the RNA polymerase ␤ subunit (rpoB) gene, and multilocus sequence typing (MLST). The results were then compared. Antimicrobial susceptibility testing was also performed to determine the multidrug resistance phenotypes of these epidemic strains. MATERIALS AND METHODSBacterial strains. Over the 11-year period from 1997 to 2007, an initial 814 A. baumannii strains isolated from clinical settings and suspected of being involved in nosocomial outbreaks were sent to the Spanish National Center for Microbiology (CNM) for typing. Strains were isolated from 19 public hospitals in 17 Spanish provinces. Hospitals were coded H1 to H19, and provinces were coded P1 to P17. The type of clinical sample, the hospital ward of origin, and the isolation per...

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Section: Discussionmentioning

confidence: 94%

Clonal Diversity of Nosocomial Epidemic Acinetobacter baumannii Strains Isolated in Spain

et al. 2011

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“…The organism's ability to survive under a wide range of environmental conditions and to persist for extended periods of time on surfaces make it a frequent cause of outbreaks of infection and an endemic, health care-associated pathogen [31,32]. In many studies Acinetobacter baumannii has been reported as a cause of meningitis as hospital acquired infection or acquired after neurosurgical procedures [33][34][35][36][37][38].…”

Section: Gram Negative Acute Bacterial Meningitis An Emerging Entity mentioning

confidence: 99%

Gram Negative Acute Bacterial Meningitis an Emerging Entity in a Tertiary Care Centre, New Delhi

Kasana¹

2016

JBMOA

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“…This principle is difficult to demonstrate by experiment. However, levels of environmental contamination with Acinetobacter baumannii in intensive care units correlate with colonisation and infection of patients [16], nasal colonisation with MRSA is a risk factor for subsequent MRSA septicaemia [6], and asymptomatic colonisation with Staphylococcus aureus is associated with a greater risk of wound infection [5].…”

Section: Discussionmentioning

confidence: 99%

Contamination of anaesthetic machines with pathogenic organisms*

Baillie

Sultan

Graveling³

et al. 2007

Anaesthesia

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SummaryHospital-acquired infections are commonly resistant to antibiotics and cause substantial morbidity and mortality in susceptible populations. Although there is no direct contact between the anaesthetic machine's controls and the patient, there is considerable potential for colonising organisms to be carried between the anaesthetic machine and the patient on the anaesthetist's hands. We performed two cross-sectional studies of bacterial contamination on anaesthetic machines before and after a simple intervention. Without warning, during theatre sessions, bacterial cultures were obtained from anaesthetic equipment. A new departmental policy of cleaning anaesthetic equipment with detergent wipes between cases was then introduced. Six weeks later, again without warning, a further set of cultures was taken. There was significant reduction in the proportion of cultures containing pathogenic bacteria (from 14 ⁄ 78 cultures (18%; 95% CI 9.4-26.5%) before the intervention to 5 ⁄ 77 cultures (6%; 95% CI 1.0-12%) after the intervention (p = 0.03)). The intervention was quick, easy and enthusiastically taken up by the majority of staff. We conclude that cleaning of anaesthetic equipment between cases should become routine practice.

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Role of environmental cleaning in controlling an outbreak of Acinetobacter baumannii on a neurosurgical intensive care unit

Cited by 67 publications

References 19 publications

Clonal Diversity of Nosocomial Epidemic Acinetobacter baumannii Strains Isolated in Spain

Clonal Diversity of Nosocomial Epidemic Acinetobacter baumannii Strains Isolated in Spain

Gram Negative Acute Bacterial Meningitis an Emerging Entity in a Tertiary Care Centre, New Delhi

Contamination of anaesthetic machines with pathogenic organisms*

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